Melfam
Melfam Uses, Dosage, Side Effects, Food Interaction and all others data.
An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer - medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen.
Melfam is an antineoplastic in the class of alkylating agents and is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands - directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result - disruption of DNA function and cell death.
| Trade Name | Melfam |
| Availability | Prescription only |
| Generic | Melphalan |
| Melphalan Other Names | L-PAM, L-Phenylalanine mustard, L-Sarcolysine, Melfalano, Melphalan, Melphalanum, p-L-Sarcolysin, Phenylalanine mustard, Phenylalanine nitrogen mustard |
| Related Drugs | carboplatin, doxorubicin, cisplatin, paclitaxel, Revlimid, Avastin, Lynparza, Velcade, Darzalex, Pomalyst |
| Type | Tablet |
| Formula | C13H18Cl2N2O2 |
| Weight | Average: 305.2 Monoisotopic: 304.074533244 |
| Protein binding | Moderate to high (60 to 90%), primarily to albumin and, to a lesser extent, alpha 1-acid glycoprotein. 30% is irreversibly bound. |
| Groups | Approved |
| Therapeutic Class | |
| Manufacturer | Amronco Lifesciences Limited |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Melfam is an alkylating antineoplastic agent used to treat multiple myeloma and ovarian carcinoma.
For the palliative treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary. Has also been used alone or as part of various chemotherapeutic regimens as an adjunct to surgery in the treatment of breast cancer, alone or in combination regimens for palliative treatment of locally recurrent or unresectable in-transit metastatic melanoma of the extremities, as well as for the treatment of amyloidosis with prednisone.
Melfam is also used to associated treatment for these conditions: Amyloidosis, Multiple Myeloma (MM), Ovarian Epithelial Cancer, Severe Hodgkin Lymphoma, Conditioning regimens for allogeneic stem cell transplantation therapy
How Melfam works
Melfam attaches alkyl groups to the N-7 position of guanine and N-3 position of adenine, leading to the formation of monoadducts, and DNA fragmenting when repair enzymes attempt to correct the error. It can also cause DNA cross-linking from the N-7 position of one guanine to the N-7 position of another, preventing DNA strands from separating for synthesis or transcription. Finally, melphalan can induce a number of different mutations.
Toxicity
Vomiting, ulceration of the mouth, diarrhea, and hemorrhage of the gastrointestinal tract; The principal toxic effect is bone marrow suppression. LD50=11.2 mg/kg (orally in rat)
Food Interaction
- Drink plenty of fluids.
- Take on an empty stomach. Food decreases absorption and decreases bioavailabilty by approximately 30%.
Melfam Disease Interaction
Major: infections, myelosuppressionModerate: pulmonary pneumonitis/fibrosis, renal dysfunction
Volume of Distribution
- 0.5 L/kg
Elimination Route
Incomplete, variable, 25-89% post oral dose
Half Life
1.5 (±0.83) hours
Elimination Route
The 24-hour urinary excretion of parent drug in these patients was 10% ± 4.5%, suggesting that renal clearance is not a major route of elimination of parent drug.
Innovators Monograph
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