Dosing & Uses
Multiple Myeloma
In February 26. 2021, FDA approves melphalan flufenamide (Pepaxto) for use in combination with dexamethasone in adults with relapsed or refractory multiple myeloma
Pharmacology
Mechanism of Action
Melphalan alkylates DNA at the N7 position of guanine residues and induces DNA intra- and inter-strand cross-linkages. This results in the inhibition of DNA and RNA synthesis and the induction of apoptosis, thereby inhibiting tumor cell proliferation.
Prodrug where melphalan is bound to flufenamide; once administered, the dipeptide bond is hydrolyzed by peptidases, which are overexpressed by certain cancer cells; this results in release and accumulation of the active metabolite melphalan in cancer cells allowing for enhanced efficacy and reduced toxicity compared with conventional melphalan
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
