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Administration
Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
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Contraindications
Hypersensitivity. Pregnancy and lactation.
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Special Precautions
Patients with compromised bone marrow reserve due to prior irradiation or chemotherapy, or whose marrow function is recovering from previous cytotoxic therapy. Renal impairment. Elderly. Monitoring Parameters Monitor CBC with differential, platelet count, serum electrolytes, renal/liver function tests, serum uric acid; signs and symptoms of hypersensitivity reaction, pulmonary or gastrointestinal toxicity.
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Adverse Reactions
Significant: Bone marrow depression leading to leucopenia, thrombocytopenia and anaemia; secondary malignancies (e.g. myeloproliferative syndrome, acute myeloid leukaemia), gastrointestinal toxicity (including nausea, vomiting, diarrhoea, stomatitis), hepatitis, jaundice, hypersensitivity reactions (including anaphylaxis), interstitial pneumonitis, suppression of ovarian function (in premenopausal women), testicular suppression, extravasation causing local tissue damage.
General disorders and administration site conditions: Fatigue, pyrexia, transient warm and tingling sensation at inj site (IV).
Investigations: Abnormal LFTs, increased blood urea and blood creatine phosphokinase.
Metabolism and nutrition disorders: Hypokalaemia (IV).
Musculoskeletal and connective tissue disorders: Myalgia, muscle atrophy or fibrosis, compartment syndrome.
Skin and subcutaneous tissue disorders: Alopecia.
Potentially Fatal: monary fibrosis. |
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Drug Interactions
May enhance the adverse/toxic effect of live vaccines, cisplatin, and carmustine. May enhance the nephrotoxic effect of ciclosporin. May enhance the adverse/toxic effect (e.g. necrotic enterocolitis in paediatric patients) with nalidixic acid.
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CIMS Class
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ATC Classification
L01AA03 - melphalan ; Belongs to the class of alkylating agents, nitrogen mustard analogues. Used in the treatment of cancer.
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