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melphalan
generic
Black Box Warnings .
Appropriate Use
admin. only under supervision of physician experienced in cancer chemotherapy
Myelosuppression
severe myelosuppression leading to infection or bleeding may occur; incr. myelosuppression w/ IV formulation compared to oral formulation
Hypersensitivity Rxn
occur in 2% of pts receiving IV formulation, incl. anaphylaxis
Secondary Malignancy
incl. acute nonlymphocytic leukemia
Mutagen
produces chromosomal aberrations in vitro and in vivo, thus consider potentially mutagenic in humans
Adult Dosing .
Dosage forms: TAB: 2 mg; INJ: various
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
multiple myeloma, autologous HSCT conditioning tx
- [100 mg/m^2/dose IV q24h on days -3, -2 prior to transplantation]
- Info: use adjusted IBW for dose calculations if wt >130% of IBW
multiple myeloma, palliative tx
- [PO route]
- Dose: 6 mg PO qd x2-3wk, then off for up to 4wk until WBC and PLT count recovery, then 2 mg PO qd; Info: see pkg insert for alternative dosing options
- [IV route]
- Dose: 16 mg/m^2/dose IV x1 on day 1 of 28-day cycle, starting cycle 5; Start: 16 mg/m^2/dose IV x1 on day 1 of 14-day cycle x4 cycles
ovarian CA, palliative tx
- [0.2 mg/kg/dose PO qd on days 1-5 of 28- or 35-day cycle]
renal dosing
- [HSCT conditioning tx]
- renal impairment: no adjustment
- HD/PD: not defined
- [palliative tx]
- CrCl 10-50: decr. usual dose by 25%; CrCl <10: decr. usual dose by 50%
- HD: decr. usual dose by 50%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 50%; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.