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美法侖

Melphalan

4-[bis(2-chloroethyl)amino]-L-phenylalanine

抗腫瘤藥 - 烷化劑POIV

別名: Alkeran · L-PAM · Phenylalanine mustard · L-sarcolysin

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

各物種劑量

此藥的劑量資料尚未收錄於 VetSheet 藥典，以下其他章節資料完整。處方前請參閱最新藥品說明書。

概覽

美法侖（Melphalan）是一種細胞毒性烷化劑，在獸醫腫瘤學中主要用於治療​多發性骨髓瘤​。它也可作為犬淋巴瘤救援方案中環磷醯胺的替代品，以及用於治療某些實體腫瘤（如卵巢癌、骨肉瘤、肺部和乳腺腫瘤）。

​臨床警告：​ 美法侖是一種強效細胞毒性藥物。必須嚴格遵守安全處理程序，以防止醫護人員和飼主意外接觸。

作用機制

Melphalan acts as a bifunctional alkylating agent. It forms inter- and intrastrand cross-links with DNA → alters DNA structure → inhibits DNA synthesis and function, ultimately leading to cell death (apoptosis), particularly in rapidly dividing neoplastic cells.

安全性與警告

禁忌症

  • Bone marrow suppression
  • Concurrent infection
  • Impaired renal function

不良反應

  • Myelosuppression (leucopenia, thrombocytopenia)
  • Anorexia
  • Nausea
  • Vomiting
  • Pulmonary infiltrates
  • Pulmonary fibrosis
  • Oral ulceration (reported in humans)

注意事項

​Cytotoxic Handling:​ Melphalan is a cytotoxic drug; refer to specialist texts for safe handling and administration of chemotherapeutic agents.

​Dosing Warning:​ Take extreme care when dosing small dogs using their body surface area (BSA). There is a significant risk of overdose due to the fixed tablet sizes. ​Tablets should not be split.​

  • ​Administration:​ Give tablets on an empty stomach to maximize absorption.
  • ​Toxicity:​ Myelosuppression is the dose-limiting toxicity; its effects may be prolonged and cumulative.

藥物相互作用

CimetidineModerate

Decreases the oral bioavailability of melphalan

SteroidsModerate

Enhance the antitumour effects of melphalan

CiclosporinMajor

Enhances the risk of renal toxicity (reported in humans)

監測

  • Complete Blood Count (CBC) - monitor for leucopenia and thrombocytopenia
  • Renal function panel
  • Gastrointestinal signs (anorexia, vomiting)
  • Respiratory rate and effort (for pulmonary infiltrates/fibrosis)

藥物動力學

半衰期

狗Approximately 1-2 hours

吸收

Oral absorption is highly variable and incomplete. Administration with food significantly decreases bioavailability.

分佈

Distributes rapidly into total body water; moderate protein binding.

代謝

Undergoes spontaneous chemical degradation (hydrolysis) rather than extensive hepatic metabolism.

排除

Eliminated primarily via the kidneys as inactive metabolites and some unchanged drug.

過量

Overdosage primarily manifests as severe myelosuppression (profound neutropenia and thrombocytopenia) and severe gastrointestinal toxicity (vomiting, diarrhea, ulceration). Treatment is supportive, including broad-spectrum antibiotics for neutropenia, antiemetics, and potentially blood transfusions or colony-stimulating factors.

可用產品

劑型

  • Oral: 2 mg tablet
  • Injection: 50 mg powder in vial plus diluent

人用標示

  • Alkeran 2 mg tablets
  • Alkeran 50 mg powder for injection

各地核准狀態

United States✓ 已核准處方藥FDA

Human-approved drug used off-label in veterinary medicine.

European Union✓ 已核准處方藥EMA

POM (Prescription Only Medicine). Human-approved drug used off-label under the cascade.

United Kingdom✓ 已核准處方藥VMD

POM. Human-approved drug used off-label under the cascade.

暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Tablets should be stored in a closed, light-protected container under refrigeration (2-8°C).

飼主須知

  • ​安全處理：​ 這是一種化療藥物。在處理藥物及給藥後幾天內清理寵物排泄物（尿液、糞便、嘔吐物）時，請戴上一次性手套。
  • ​給藥方式：​ 請​空腹​給藥。​切勿壓碎、折斷或剝半藥片​。
  • ​觀察副作用：​ 密切觀察是否有感染跡象（發燒、嗜睡）、異常出血或瘀傷、食慾不振、嘔吐或腹瀉。如出現上述情況，請立即聯繫獸醫。
  • ​儲存：​ 將藥片保存在密閉、避光的容器中，並冷藏（2-8°C）。

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