Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Alkylating agent

Melphalan (Specialist drug)

Brand names: Alkeran

Melphalan is a nitrogen-mustard alkylating cytotoxic used, under specialist supervision, mainly in multiple myeloma and as high-dose conditioning before stem-cell transplantation.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It forms covalent cross-links with DNA, preventing strand separation and thereby blocking DNA replication and cell division.

Prescribing in practice

  • It causes profound, dose-dependent and sometimes prolonged bone-marrow suppression, so full blood counts must be monitored closely and treatment is delivered under specialist haemato-oncology supervision.
  • Dosing is influenced by renal function, and high-dose intravenous use requires transplant-centre support; it is a known secondary-malignancy and infertility risk.
  • It is mutagenic, teratogenic and a vesicant when given intravenously, requiring careful handling and administration.

Monitoring

Monitor full blood count regularly during and after treatment, alongside renal function which guides dosing.

Counselling the patient

  • Report fever, sore throat, bruising or bleeding promptly as your blood counts may be low.
  • Reliable contraception is essential during and after treatment, and fertility preservation may be discussed beforehand.
  • Maintain good hydration and attend all blood-test appointments.

Evidence & guidelines

Long-established in multiple myeloma and transplant conditioning per the SPC and specialist haemato-oncology protocols.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways