Melphalan interactions

Conditions

Conditions in which Melphalan needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Bone marrow suppression is the most significant toxicity associated with melphalan in most patients. The following tests should be performed at the start of therapy and prior to each subsequent dose of melphalan: platelet count, hemoglobin, white blood cell count, and differential. Thrombocytopenia and/or leukopenia are indications to withhold further therapy until the blood counts have sufficiently recovered. Frequent blood counts are essential to determine optimal dosage and to avoid toxicity. Dose adjustment on the basis of blood counts at the nadir and day of treatment should be considered.

  1 source

  1. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):

• Infections

  Major

  Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

  39 sources

  1. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  2. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories (2002):
  3. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb (2001):
  4. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):
  5. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation (2001):
  6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb (2001):
  7. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb (2001):
  8. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2001):

  Show all 39 sourcesShow fewer sources

  9. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  10. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  11. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  12. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  13. "Product Information. Fludara (fludarabine)." Berlex Laboratories (2001):
  14. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn (2001):
  15. "Product Information. Matulane (procarbazine)." Roche Laboratories (2001):
  16. "Product Information. DTIC-Dome (dacarbazine)." Bayer (2001):
  17. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
  18. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc (2001):
  19. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company (2001):
  20. "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
  21. "Product Information. Taxotere (docetaxel)." Rhone Poulenc Rorer (2001):
  22. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb (2001):
  23. "Product Information. Nipent (pentostatin)." Hospira Inc (2001):
  24. "Product Information. Tabloid (thioguanine)." Prasco Laboratories (2001):
  25. "Product Information. Xeloda (capecitabine)." Roche Laboratories (2001):
  26. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):
  27. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome (2001):
  28. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  29. "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
  30. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn (2001):
  31. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation (2001):
  32. "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):
  33. "Product Information. Halaven (eribulin)." Eisai Inc (2010):
  34. "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc (2014):
  35. "Product Information. Blincyto (blinatumomab)." Amgen USA (2014):
  36. "Product Information. Opdivo (nivolumab)." Bristol-Myers Squibb (2014):
  37. "Product Information. Unituxin (dinutuximab)." United Therapeutics Corporation (2015):
  38. "Product Information. Empliciti (elotuzumab)." Bristol-Myers Squibb (2015):
  39. "Product Information. Pepaxto (melphalan flufenamide)." Oncopeptides Inc. (2021):

• Kidney Diseases

  Moderate

  The incidence of myelosuppression, particularly during IV administration of melphalan, is increased in patients with a BUN > 30 mg/dl. Therapy with melphalan should be administered cautiously and initiated at a reduced dosage in patients with moderate to severe renal impairment. Clinical monitoring of renal function is recommended.

  1 source

  1. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):

• Pulmonary Fibrosis

  Moderate

  Interstitial pneumonitis and/or fibrosis (including fatal outcomes), have been reported occasionally during melphalan therapy. Therapy with melphalan should be administered cautiously in patients with or predisposed to pulmonary dysfunction.

  1 source

  1. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):