Melphalan Pharmacology

Melphalan

About Melphalan
Nitrogen mustard alkylating agent, Antineoplastic.
Mechanism of Action of Melphalan
This nitrogen mustard group alkylating agent forms unstable ethylenimmonium ions, which alkylate or binds with intracellular molecular structures including nucleic acids. Its cytotoxic activity is primarily due to cross linking of strands of DNA & RNA, as well as inhibition of protein synthesis.
Pharmacokinets of Melphalan
Absorption- After oral administration there is incomplete absorption.
Rapidly absorbed after intravenous administration.
Distribution - Rapidly and widely distributed in the body.90% bound to the plasma proteins.
Metabolism - Metabolized into metabolites by hydrolysis.
Excretion - Excreted via urine and through feces.10% excreted as unchanged form.
Onset of Action for Melphalan
Few minutes to 6 hrs
Duration of Action for Melphalan
90 minutes
Half Life of Melphalan
Initial half life is about 8 min. and terminal half life is about 2 days.
Side Effects of Melphalan
1. Nausea
2. Vomiting
3. Lowered resistance to infection
4. Bruising or unusual bleeding
5. Anemia
6. Weakness
7. Sore in mouth
8. Taste changes
9. Diarrhea
10. Loss of appetite
11. Visual changes
12. Black, tarry stools
13. Blood in urine or in stool
14. Cough or hoarseness
15. Fever
16. Chills
17. Lower back or side pain
18. Painful or difficult urination
19. Pinpoint red spot on skin
20. Slurred speech
21. Swelling on leg or lower leg
22. Shortness of breath
23. Pulmonary fibrosis
24. Hepatotoxicity
25. Lethargy
26. Ataxia
27. Thrombocytopenia
28. Leucopenia
29. Bone marrow suppression
30. Stomatitis
31. Pruritis
32. Suppression of ovarian function in pre menopausal woman
33. Temporary or permanent sterility in male
34. Inappropriate secretion of ADH.

Contra-indications of Melphalan
1. Hypersensitivity to this drug or chlorambucil
2. Severe bone marrow suppression
3. Chicken pox
4. Herpes zoster virus infection
Special Precautions while taking Melphalan
1. Impaired renal function
2. Severe leucopenia
3. Thrombocytopenia
4. Anemia
5. Chronic lymphocytic leukemia
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Melphalan
1. Breast cancer
2. Waldenstrom`s macroglobulinaemia
3. Blood cancer
4. Lymphoma
5. Cancer of endometrium
6. Malignant melanoma
7. Multiple myeloma
8. Advanced ovarian cancer
9. Solid tumors
10. Polycythemia Vera
Interactions for Melphalan
Cyclosporine: Potential risk of severe renal failure.
Carmustine: The carmustine lung toxicity threshold may be reduced.
Cisplatin: Induces renal dysfunction resulting in altered melphalan clearance.
Nalidixic Acid: May cause severe haemorrhagic necrotic enterocolitis in children.
Typical Dosage for Melphalan
Oral-
Adults-
For multiple myeloma- 6mg/day and maintenance dose 2mg/day.
Children - 0.15mg/kg/day for 7 days.
For ovarian carcinoma - 0.2mg/kg/day for 5 days. Repeat the course after 4 to 5 weeks.
Intravenous-
Adults-
16mg/m2 over 15 to 20 minutes once at 4 week interval for 4 doses.
Schedule of Melphalan
N/A
Storage Requirements for Melphalan
Store at room temperature, away from heat and direct light.
Keep out of reach of children.
Effects of Missed Dosage of Melphalan
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Melphalan
Give symptomatic and supportive treatment.

Home Delivery for Melphalan in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including melphalan.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for melphalan and other medicines and health products. Home delivery services for melphalan may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take melphalan only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for melphalan before they complete the sale. You can get this information while placing the order for melphalan with the pharmacy.

Melphalan is a generic medicine name and there are several brands available for it. Some of the brands for melphalan might be better known than melphalan itself. If the pharmacy that's willing to deliver medicines to your home doesn't have melphalan in stock, you can ask for one of the branded alternatives for melphalan.