Alkeran

Drugs

Generic Name: Melphalan
Product Name: Alkeran

Indication of Alkeran
Action of Alkeran
Dose advice of Alkeran
Schedule of Alkeran
Common side effects of Alkeran
Uncommon side effects of Alkeran

Indication of Alkeran:

Alkeran is used in the treatment of:

Hodgkin's lymphoma.
Non-Hodgkin's lymphoma.
Chronic lymphocytic leukaemia.
Waldenstrom's macroglobulinaemia.
Advanced ovarian adenocarcinoma.
Breast cancer.
Nephrotic syndrome.
Systemic lupus erythematosus.
Lupus nephritis.
Immune-related ocular disease.
Multiple myeloma.
Polycythaemia vera.
Malignant melanoma of the extremities.
Soft tissue sarcoma.
Mobilisation of hemopoietic stem cells for subsequent infusion after high dose myeloablative or myelosuppressive chemotherapy.

^ top

Action of Alkeran:

Melphalan acts by preventing replication of tumour cells by forming cross-linkages between DNA strands.

^ top

Dose advice of Alkeran:

Specialist protocols should be consulted.The following doses are recommended initial doses. Further courses and doses depend on the individual patient's response and side effects.Multiple myeloma:

150 micrograms/kg orally given in divided doses daily for 4-7 days.
Melphalan is given in combination with prednisolone 40-60 mg daily for 4 days.

High dose therapy:

100-200 mg/m 2 intravenously daily.
Melphalan is given in combination with autologous hemopoietic stem cell support.

Renal impairment:

In patients with moderate to severe renal impairment intravenous doses should be halved and reduction of oral doses should be considered.
High dose therapy should not be used in patients with moderate to severe renal impairment.

Pregnancy:

Melphalan can cause spontaneous abortion, foetal loss and birth defects and should be avoided during pregnancy. It should also be avoided during breastfeeding.

^ top

Schedule of Alkeran:

^ top

Common side effects of Alkeran:

Bone marrow suppression, which can result in low white cell and platelet counts, which can cause an increased susceptibility to infections and bleeding respectively.
Nausea.
Vomiting.
Diarrhoea.
Mouth ulcers (common at high doses).
Hair loss (very common at high doses).
Amenorrhoea (absence of menstruation in women).

^ top

Uncommon side effects of Alkeran:

Temporary or permanent infertility in both women and men.
Hypersensitivity, allergy or anaphylaxis.
Liver disease ranging from abnormal blood tests to hepatitis (inflammation of the liver) and jaundice (yellowing of the skin and white parts of the eyes due to increased bilirubin in the blood).
Temporarily raised blood urea in patients with multiple myeloma with damaged kidneys (seen on a blood test).
Interstitial pneumonitis (inflammation of the tissues in the lung).
Pulmonary fibrosis (chronic scarring of the lung tissue).
Melphalan may increase the risk of leukaemia and secondary malignancies (cancers) developing.
Overdose may result in severe nausea, vomiting, diarrhoea, damage to the gut lining, inflammation of the tissues in the gut and mouth, bleeding, abnormal blood clotting, decreased consciousness, convulsions or paralysis.

^ top