Therapeutic Category
- Antineoplastic Agent, Alkylating Agent
- Antineoplastic Agent, Alkylating Agent (Nitrogen Mustard)
Medication Safety Issues
Melphalan may be confused with melphalan flufenamide, Mephyton, Myleran
Alkeran may be confused with Alferon, Leukeran, Myleran
This medication is in a class the Institute for Safe Medication Practices (ISMP) includes among its list of drug classes which have a heightened risk of causing significant patient harm when used in error.
Different formulation issues: IV melphalan is available as different salt forms and different IV formulations. Evomela (melphalan for injection) is a lyophilized powder which is reconstituted with normal saline to a 5 mg/mL concentration. Alkeran (melphalan hydrochloride for injection) and generic melphalan hydrochloride are also powder formulations which are reconstituted with the supplied diluent (which contains propylene glycol and ethanol) to a 5 mg/mL concentration. Melphalan flufenamide (Pepaxto) is a prodrug of melphalan. Indications for use, product preparation, storage, and dosing differ between salt forms and formulations. Use caution when selecting melphalan formulations for preparation and administration. Do not mix or combine the formulations. Do not substitute melphalan hydrochloride for melphalan flufenamide.
