Classes
DEA Class; Rx
Common Brand Names; Alkeran (DSC), Evomela
- Antineoplastics, Alkylating
Description
Alkylating agent
Used in the palliative treatment of unresectable epithelial ovarian cancer (Alkeran tablets), the palliative treatment of multiple myeloma (Alkeran tablets or injection), and as a high-dose conditioning treatment prior to an autologous stem-cell transplant in patients with multiple myeloma (Evomela)
Boxed warnings for severe myelosuppression resulting in infection or bleeding; hypersensitivity reactions, including anaphylaxis; and risk of secondary malignancy, primarily leukemia
Indications
Indicated for palliative treatment of nonresectable epithelial ovarian carcinoma
Contraindications
Hypersensitivity
Adverse Effects
- Hypersensitivity to melphalan or chlorambucil
- Prior resistance to melphalan
Warnings
Renal impairment, leukopenia, thrombocytopenia, anemia, CLL
Possibility of delayed myelosuppression that can last 4-6 wk
Avoid pregnancy
Pregnancy and Lactation
Based on mechanism of action, therapy can cause fetal harm when administered to a pregnant woman, including teratogenicity and/or embryo-fetal lethality; product is a genotoxic drug and can cause chromatid or chromosome damage in humans
It is not known whether drug is present in human milk; because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing children from melphalan, breastfeeding is not recommended during treatment and for one week after last dose
Maximum Dosage
IV: 100 mg/m2 for 2 consecutive days (Evomela), use adjusted ideal body weight (IBW) in patients weighing greater than 130% of their IBW or 200 mg/m2 once (Alkeran) as conditioning therapy prior to an autologous stem-cell transplant; 16 mg/m2 IV repeated every 2 to 4 weeks as palliative therapy for multiple myeloma.
Oral: The maximum dose depends on the indication and on drug-related toxicity.
IV: 100 mg/m2 for 2 consecutive days (Evomela), use adjusted ideal body weight (IBW) in patients weighing greater than 130% of their IBW or 200 mg/m2 once (Alkeran) as conditioning therapy prior to an autologous stem-cell transplant; 16 mg/m2 IV repeated every 2 to 4 weeks as palliative therapy for multiple myeloma.
Oral: The maximum dose depends on the indication and on drug-related toxicity.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Melphalan Hydrochloride
injection, lyophilized powder for reconstitution
- 50mg (Evomela, generic)
tablet
- 2mg (generic)
