ALKERAN (Melphalan)  

Generic name: Melphalan 

Trade name Alkeran 

Other names: L-PAM, L-Sarcolysin, Phenylalanine Mustard 

Dosage form: Alkeran can be taken by intravenous injection (IV) and/or as tablets by mouth, on an empty stomach.  

Chemotherapy type: Alkeran is classified as a nitrogen mustard alkylating agent  

Manufacturer/Distributor : Celgene Corporation 

Disponibilty: Alkeran is available by prescription only    

Indications: Alkeran is used in the treatment of:  

• multiple myeloma 
• ovarian cancer  
• malignant melanoma 
• rhabdomyosarcoma   
• Breast cancer - in advanced stages or in addition to surgical treatment.  

   Occasionally, Alkeran is used to treat the following cancers: 

• testicular cancer
• advanced prostate cancer 
• chronic myelogenous leukemia, one of four main types of leukemia
• Osteogenic sarcoma, one of the most common forms of bone cancer in children.

Note: your doctor can use the drug to treat other medical conditions non-mentioned in this article if he believes it can be helpful.  

Contraindication/precautions: ALKERAN is contraindicated in the following conditions: 

·         allergy to Alkeran or one of its components  

·         breastfeeding is not recommended while taking Alkeran 

·         Pregnancy - using Alkeran is not recommended during pregnancy, especially during the first quarter; the drug may cause problems which can be harmful to the fetus 

·         Elderly, infants and children are treated with Alkeran under strict medical supervision. 

If you have one of the following medical conditions, let it be known to your doctor before beginning an Alkeran treatment: 

• lactase deficiency  
• kidney problems 
•   fructose intolerance  
• galactosemia 
• glucose-galactose malabsorption  
• You have been treated with radiotherapy or antineoplastic agents during the previous 3 weeks.   

Mechanism of Action (MOA) - Alkeran destroys cancer cells by forming cross-linkages between DNA strands (deoxyribonucleic acid), which thereby inhibiting the replication of tumor cells. 

Interactions : Alkeran may be toxic or cause serious infections when it is associated with nalidixic acid (Neggram) , cyclosporine or other immunosuppressants. In addition, the association of high-dose Alkeran and cyclosporine is toxic to the kidney.   

Side effects : Alkeran attack not only cancer cells but healthy cells that multiply quickly, which often leads to adverse effects. The most common Alkeran side effects include:    

• fatigue
• loss of appetite 
• loss of weight 
• hair loss 
• weakness
• nausea and vomiting
• rash and itching
• increased risk of bleeding
• Pulmonary fibrosis (rare)
• Mouth blistering, sometimes inflammation of the mouth.

See your doctor immediately if you experience any of the following symptoms:  

•   fever  
•   dizziness 
•   chills 
•   sore throat 
•   green, black, tarry stools 
•   red urine or blood in urine  
•   persistent cough 
•   missed menstrual periods 
•   yellowing of the skin or eyes 
•  increased risk of infection  
• Difficulty breathing or shortness of breath.