Drug Interaction:
Alkylating Agents Includes-
Mechlorethamine ,Chlorambucil, Melphalan, Ifosamide,Cyclophosphamide, Urasil Mustard,
Lomustine, Carmustine, Streptozocin, Thiotepa, Busulfan, Pipobroman, Cisplatin, Carboplatin
Interacting drugs- summary
+ Melphalan
Cyclosporine +
severe renal failure has occured with a single IV dose of Melphalan,
followed by standard oral cyclosporine doses
Nalidixic acid +
severe hamorrhagic necrotic entero- colitis may increase in pediatric
patients
Melphalan +
Carmustine
Carmustine lung toxicity threshold increased.
Indication:
Paliative treatment of multiple myloma, ovarian carcinoma.
Adverse Reaction:
Agranulocytosis and marrow depression. Secondary leukemia, Allergic reactions. Nausea, vomiting, Hair loss, rash and pruritis. Direct Coombs test positive.
Contra-Indications:
Hyperesens,myelosuppression.
Special precautions:
Use under medical supervision. Monitor blood counts. Renal impairment. Pregnancy and lactation. Tablets should not be divided.
Dosages/ Overdosage Etc:
Indications:
Paliative treatment of multiple myloma, ovarian carcinoma.
Dosage:
Oral - usual dose 6mg/day. Then entire daily dose may be given at one time. Maintenance dose of 2mg/day.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Melphalan or chlorambucil.
2.Pregnancy-
There is a chance that this medicine may cause birth defects if either the male
or female is taking it at the time of conception or taken during pregnancy.
Tell your doctor if you bcome pregnant while taking this medicine
3. Breast-feeding-
Because melphalan may cause serious side effects breast feeding is not
recommended while you are taking it.
4.Children-
There is no specific information about use of melphalan in children.
5.Older adults-
There is no specific information about the use of melphalan in the elderly.
6. Other medicines-
Tell your doctor if you are using any of the following-
Amphotericin or
Antithyroid agents or
Azithromycin or
Chloramphenicol or
Flucytosine or
Plicamycin or
Zidovudine or if you been treated with x-rays or cancer medicines- melphalan
may increase the effects of these medicines
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Chicken pox including recent exposure or
Herpes zoyster or
- risk of severe disease affecting the other parts of the body.
Gout or
Kidney disease - melphalan may increase levels uric acid in the
body which can cause kidney stones
Infection - Melphalan can reduce immunity to infection
Kidney disease
Pharmacology/ Pharmacokinetics:
Pharmacology:
Mephalan, a phenylalnine derivative of nitogen mustard, is a bifuntional alkylating agent. Its cytotoxicity appears to be related to the extent of its interstrand cross-linking with DNA. It is active against both resting and rapidly dividing tumor cells.
Pharmacokinetics:
Plasma half life is approximately 90 min. about 10% is excreted unchanged in urine in 24 hours.
Interaction with Food:
Reduction in bioavailability
Pregnancy and lactation:
Use contraindicated. Observe caution Refer cholrambucil - akylating agent.
Manufacturer Details