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Melphalan

    Brands

    DEA Class; Rx

    Common Brand Names; Alkeran (DSC), Evomela

    • Antineoplastics, Alkylating

    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

    Indicated for the treatment of multiple myeloma.

    Indicated for palliative treatment of nonresectable epithelial ovarian carcinoma

    Hypersensitivity

    • Hypersensitivity to melphalan or chlorambucil
    • Prior resistance to melphalan

    Renal impairment, leukopenia, thrombocytopenia, anemia, CLL

    Possibility of delayed myelosuppression that can last 4-6 wk

    Avoid pregnancy

    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

    Adults

    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.

    Geriatric

    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.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Melphalan Hydrochloride

    injection, lyophilized powder for reconstitution

    • 50mg (Evomela, generic)

    tablet

    • 2mg (generic)