💊 DESCRIPTION
Melphalan is an alkylating agent used primarily in the treatment of multiple myeloma and ovarian carcinoma, and sometimes for bone marrow transplantation conditioning. It interferes with DNA replication and transcription, leading to cancer cell death.
- Form: Tablet
- Strength: 2 mg
- Route: Oral
- Drug Class: Alkylating agent (Nitrogen mustard derivative)
- Common Brand Names: Alkeran®, Melphalan Tablets IP, etc.
✅ ADVANTAGES
- Effective in multiple myeloma, both in newly diagnosed and relapsed cases
- Useful in high-dose regimens before bone marrow/stem cell transplant
- Oral formulation offers non-invasive dosing
- May reduce the size and progression of solid tumors and hematologic cancers
- Often part of combination chemotherapy regimens
🌿 NATURE / MECHANISM
- Alkylates DNA, forming cross-links between DNA strands
- Prevents DNA and RNA synthesis, leading to cell cycle arrest and apoptosis
- Non-cell-cycle specific, but most effective during DNA synthesis phase (S phase)
- Targets rapidly dividing cells, which makes it effective against cancer
⚠️ PRECAUTIONS
- Bone marrow suppression is the most significant toxicity:
- Leukopenia, thrombocytopenia, anemia – frequent monitoring of blood counts is essential
- Nausea, vomiting, and diarrhea may occur
- Secondary malignancies (especially leukemia) with long-term use
- Hypersensitivity reactions, though rare, have been reported
- Use with caution in patients with renal impairment – dose adjustment may be needed
- Immunosuppression increases risk of infection – monitor closely
- Avoid live vaccines during treatment
- Use contraception during and after treatment due to potential teratogenic effects
🧊 STORAGE
- Store at controlled room temperature (20–25°C)
- Protect from moisture and heat
- Do not refrigerate or freeze
- Store in original container, tightly closed
- Keep out of reach of children
👨⚕️ PATIENT ADVICE
- Take exactly as prescribed, usually on an empty stomach or as directed
- Swallow tablets whole – do not chew or crush
- Do not miss doses; if missed, consult your doctor (do not double dose)
- Notify your doctor if you experience:
- Fever, sore throat, or signs of infection
- Easy bruising or bleeding
- Mouth sores or gastrointestinal upset
- Regular blood tests (CBC, renal function) will be necessary
- Hydration is important to reduce renal toxicity
- Use effective contraception during and after treatment
- Avoid contact with people who are sick or recently received live vaccines
- Tablets should be handled carefully – wash hands after handling
📦 PACKAGING
- Usually packed in blister strips or HDPE bottles
- Each strip/bottle contains Melphalan 2 mg tablets, marked for identification
- Outer carton includes:
- Drug name and strength
- Cytotoxic warning label
- Batch number, manufacturing, and expiry date
- Supplied with prescribing information leaflet and handling precautions