Melphalan is an
anti-tumor drug used in cancer treatment. It interferes with the development of cancer cells and retards their
growth and proliferation in the body. Alkeran (Melphalan) is also known as L-phenylalanine mustard,
phenylalanine mustard, L-PAM, or L-sarcolysin; and is a phenylalanine imitative of nitrogen mustard.
The drug comes in
injection and tablet form. In addition to advanced stage prostate cancer, the tablets are indicated for the
treatment of breast cancer and epithelial carcinoma (cancer of the ovary). Intermittently, this drug is
indicated in the treatment of testicular cancer, osteogenic sarcoma (common form of bone cancer in children).
(Melphalan) is also recommended to treat multiple myeloma, a type of blood cancer. Multiple myeloma is regarded
as an excessive production of abnormal plasma cells. The patients of multiple myeloma experience weight loss,
frequent urination, bone pain, frequent infections, constipation etc.
Dosage: Alkeran can be taken by intravenous
injection (administered in vein) and also as oral tablets on an empty stomach. A typical oral dosage of Alkeran
is 16 mg/m2. This dosage should be reduced up to 50% in patients with kidney problems or renal insufficiency.
Patients with multiple myeloma attain better results while using the drug orally.
of Alkeran for the treatment of ovarian cancer is to administer single course of 0.2mg/kg daily for 5 days.
Based upon the hematologic tolerance, the course of treatment may be repeated for 4 to 5 weeks.
contraindications under certain conditions. Allergy may occur due
to the usage of this drug or one of its components. Breast feeding is not recommended with the use of Alkeran.
It is advisable not to take this drug during first quarter of pregnancy lest there may be destructive effects on
the fetus. Infants, children and elderly people who are treated
with Alkeran (Melphalan) are to be supervised under strict medical conditions.
beginning an Alkeran treatment, conditions of lactase deficiency, kidney problems, galatosemia, fructose
intolerance, glucose-galactose malabsorption must be considered. If patient has undergone radiotherapy or
antineoplastic agents in previous 3 weeks, the doctor must be consulted before taking this medicine.
Mechanism of Action
(MOA): Alkeran, a phenylalanine derivative
of nitrogen mustard, helps in destruction of cancer cells by forming cross- linkages between DNA strands,
which thereby reduce the reproduction of tumor cells.
– This drug is an
alkylating agent that preventing cell replication.
- The absorption of this
drug is variable with its bio-availability in the range of 56±27%. Its elimination half-life is 90±57 min where
11% of Alkeran gets recovered in the urine above 24 hrs.
Alkeran when coupled
with nalidixic acid (Neggram), cyclosporine or other immunosuppressant may result in serious and toxic
infections. The over dosage of Alkeran may also result in kidney problems.
Alkeran can result in minor to major side effects like gastrointestinal effects in the form of vomiting, nausea,
and diarrhea. Over dosing can also lead to few toxic effects in the form of leucopenia, anemia and
experiencing any of the over dosing side effects of Alkeran, doctor must consulted at earliest who would
institute relevant supportive measures.