Generic/ Trade Generic Name: melphalan

Name Trade Name: Alkeran, Evomela

Dosage/ Availability: Injection, Powder for Reconstitution: 50 mg.

Frequency Tablets (Alkeran): 2 mg.
Route: P.O. & I. V
PHARMACOTHERAPEUTIC: Alkylating agent
Classification
CLINICAL: Antineoplastic

Inhibits protein synthesis primarily by cross-linking strands of DNA,

Action RNA. Cell cycle–phase nonspecific. Therapeutic Effect: Disrupts nucleic
acid function, producing tumor cell death.

Treatment of nonresectable epithelial ovarian carcinoma, multiple

myeloma.
Indication OFF-LABEL: Hodgkin’s lymphoma, malignant melanoma,

m
neuroblastoma, induction regimen for bone marrow and stem cell

er as
transplantation, light chain amyloidosis, Ewing’s sarcoma.

co
eH w
Contraindications: Hypersensitivity to melphalan. Resistance to prior
Contraindication melphalan therapy.

o.
& Caution
rs e
Cautions: Preexisting bone marrow suppression, renal impairment,
ou urc
pregnancy, prior chemotherapy or irradiation.
Frequent: Nausea, vomiting (may be severe with large dose).
Side Effects
Occasional: Diarrhea, stomatitis, rash, pruritus, alopecia.
o
aC s

BASELINE ASSESSMENT
vi y re

Obtain CBC, then wkly thereafter. Dosage may be decreased or

discontinued if WBC falls below 3,000 cells/mm3 or platelet count falls
below 100,000 cells/mm3. Antiemetics may be effective in
ed d

preventing/treating nausea, vomiting.

ar stu

INTERVENTION/EVALUATION
Monitor CBC with differential, serum electrolytes. Monitor for
stomatitis. Monitor for hematologic toxicity (fever, sore throat, signs of
local infection, unusual bruising/bleeding from any site), symptoms of
is

Nursing anemia (excessive fatigue, weakness), signs of hyperuricemia

Th

Considerations (hematuria, flank pain). Avoid IM injections, rectal temperatures, other

traumas that may induce bleeding.
PATIENT/FAMILY TEACHING
• Increase fluid intake (may protect against hyperuricemia).
sh

• Maintain strict oral hygiene.

• Hair loss is reversible, but new hair growth may have different color,
texture.
• Avoid crowds, those with infections.
• Report fever, shortness of breath, cough, sore throat, bleeding,
unusual bruising.
• May suppress ovarian function, leading to amenorrhea.

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