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Alkeran (melphalan) Disease Interactions

There are 4 disease interactions with Alkeran (melphalan):

Major

Antineoplastics (applies to Alkeran) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  7. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  8. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  14. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  16. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  17. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  19. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  24. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  25. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  27. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  30. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  31. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
View all 31 references
Major

Melphalan (applies to Alkeran) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, Bleeding, Fever

Bone marrow suppression is the most significant toxicity associated with melphalan in most patients. The following tests should be performed at the start of therapy and prior to each subsequent dose of melphalan: platelet count, hemoglobin, white blood cell count, and differential. Thrombocytopenia and/or leukopenia are indications to withhold further therapy until the blood counts have sufficiently recovered. Frequent blood counts are essential to determine optimal dosage and to avoid toxicity. Dose adjustment on the basis of blood counts at the nadir and day of treatment should be considered.

References

  1. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
Moderate

Melphalan (applies to Alkeran) pulmonary pneumonitis/fibrosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

Interstitial pneumonitis and/or fibrosis (including fatal outcomes), have been reported occasionally during melphalan therapy. Therapy with melphalan should be administered cautiously in patients with or predisposed to pulmonary dysfunction.

References

  1. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
Moderate

Melphalan (applies to Alkeran) renal dysfunction

Moderate Potential Hazard, High plausibility.

The incidence of myelosuppression, particularly during IV administration of melphalan, is increased in patients with a BUN > 30 mg/dl. Therapy with melphalan should be administered cautiously and initiated at a reduced dosage in patients with moderate to severe renal impairment. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.

Alkeran (melphalan) drug interactions

There are 216 drug interactions with Alkeran (melphalan)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.