Melphalan

Melphalan is used to treat cancer of ovaries and a type of cancer of bone marrow called multiple myeloma. It may be also used to treat other conditions, as determined by the doctor. Melphalan should be taken on an empty stomach, but try to take it at the same time every day. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. It makes skin more sensitive towards sunlight, wear protective clothing or use sunscreen. The most common side effects of this medicine include nausea, vomiting, and anemia (low number of red blood cells). This medicine may reduce the number of blood cells in your blood thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with kidney, liver and heart function during treatment with this medicine. Inform your doctor if you observe signs of infections such as fever, chills, body ache or if you have unusual bruising or bleeding and bleeding gums or blood in your urine or stool. Before taking it, tell your doctor if you have bleeding, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy. Melphalan is an anti-cancer medication. It works by damaging the genetic material (DNA and RNA) of the cancer cells. This stops their growth and multiplication.

• Ovarian cancer • Multiple myeloma

Melphalan, a mechlorethamine derivative, is an alkylating antineoplastic agent. It forms carbonium ions, resulting in DNA and RNA synthesis inhibition. It cross-links DNA strands and acts on both resting and rapidly dividing tumour cells.

Adult Dose: Adult Multiple Myeloma Palliative treatment Indicated for the palliative treatment of patients with MM Oral 6 mg PO qDay for 2-3 weeks, OR 10 mg PO qDay for 7-10 days, OR 0.15 mg/kg/day PO for 7 days, THEN After adequate recovery from toxicity (monitor WBCs and platelets) give 1-3 mg or 0.05 mg/kg PO qDay Intravenous If unable to take oral, may administer IV 16 mg/m² IV as a single infusion over 15-20 minutes q2wk for 4 doses, THEN After adequate recovery from toxicity (monitor WBCs and platelets) administer q4wk Conditioning treatment Indicated for use as a high-dose conditioning treatment prior to hematopoietic progenitor (stem) cell transplantation 100 mg/m²/day IV administered over 30 min for 2 consecutive days (Day -3 and Day -2) prior to autologous stem cell transplantation (ASCT, Day 0) Patients weighing >130% of their ideal body weight, body surface area should be calculated based on adjusted ideal body weight Oral Ovarian Cancer 0.2 mg/kg/day PO for 5 days; repeat q4-5Weeks Breast cancer Adult: 150 mcg/kg daily or 6 mg/m2 daily for 5 days, repeated every 6 wk. Elderly Multiple Myeloma Induction 6 mg PO qDay for 2-3 weeks, OR 10 mg PO qDay for 7-10 days, OR 0.15 mg/kg/day PO for 7 days, OR 16 mg/m² IV q2Weeks for 4 doses Maintenance Wait until WBC and platelet counts rise 1-3 mg PO qDay, OR 0.05 mg/kg/day PO, OR 16 mg/m² IV q4Weeks Ovarian Cancer 0.2 mg/kg/day PO for 5 days; repeat q4-5Weeks Child Dose: Safety and efficacy not established Renal Dose: Renal impairment (BUN >30 mg/dL): Consider dosage reduction of up to 50%

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Melphalan is to be taken empty stomach.

If you miss a dose of Melphalan, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Nausea • Vomiting • Stomatitis (Inflammation of the mouth) • Anemia (low number of red blood cells) • Hair loss • Low blood platelets • Diarrhea • Decreased white blood cell count

[CONSULT YOUR DOCTOR] It is not known whether Melphalan alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react. Melphalan should be taken as per dose and duration suggested by the doctor.

Hypersensitivity. Severe bone marrow suppression. Pregnancy.

Potentially Fatal: Fatal haemorrhagic enterocolitis with concurrent nalidixic acid in children. Potentiates risk of renal damage with ciclosporin.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Melphalan. Please consult your doctor.

[CONSULT YOUR DOCTOR] Melphalan is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[UNSAFE] Melphalan is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

[CAUTION] Melphalan should be used with caution in patients with kidney disease. Dose adjustment of Melphalan may be needed. Please consult your doctor. [CONSULT YOUR DOCTOR] There is limited information available on the use of Melphalan in patients with liver disease. Please consult your doctor.

Please tell me the interpretation of the attach report, if possible. Also guide for further treatment process. U r having multiple myeloma Multiple myeloma can be cured or not Yes, if diagnosed at the right stage ovarian cancer stage 3 c surgery done chemotheraphy done C?se has to be seen in person before starting the treatment Pus disharge from maxilla.Patient has multiple myeloma Tooth exfoliated from the jaw post which this change was noted OPG reveals radiolucency in that site Visit to a dentist for proper treatment by surgery. Report shows higher esr value what should i do. A very high ESR usually has an obvious cause, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatica or temporal arteritis. A health practitioner will typically use other follow-up tests, such as blood cultures, depending on the person's symptoms. People with multiple myeloma or Waldenstrom's macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammationNeed to correlate clinicallyKindly consult your doctor Hypothyroidism 100 mg tablet daily.and premature ovarian failure. OK. I would like suggest you that please consult with your nearest homeopathy doctor. What is LENALIDOMIDE & why should it be taken ? Lenalidomide is a anti myeloma medicine Mouth ulcer due to duodenal multiple ulcer Take alsarex tablet 1 tablet twice, Avipattikar churan half spoon twice, kaam dudha ras 1 tablet twice, soot Sekhar ras 1 tablet twice with