Alkylating agent
Melphalan (Specialist drug)
Brand names: Alkeran
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO/IV
Frequency: per protocol
Clinical pearls
- Multiple myeloma, ovarian cancer, AL amyloidosis; high-dose conditioning before stem cell transplant
- Take on empty stomach
Contraindications
- Severe myelosuppression
- Severe renal impairment
- Pregnancy
Side effects
- Severe myelosuppression
- Mucositis (high-dose conditioning)
- Secondary malignancy
- Pulmonary fibrosis
- Hepatotoxicity
Interactions
- Live vaccines
- Other myelosuppressants
- Ciclosporin (renal toxicity)
Monitoring
- FBC
- U&E
- LFTs
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/melphalan-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Drugs
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158