Drug interactions
Denosumab + Melphalan
Severity: Moderate
Denosumab and Melphalan: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Melphalan is strongly myelosuppressive and immunosuppressive, and denosumab labeling cautions about serious infections in immunocompromised patients. The combination can increase infection risk.
What this interaction means in plain words
Denosumab and Melphalan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Denosumab belongs to Oncology; Melphalan belongs to Oncology.
Why it happens
Additive pharmacodynamic effect: alkylating agent bone marrow suppression plus RANKL inhibition.
What to do
Monitor blood counts and clinically for infection, especially during neutropenia. Use antimicrobial prophylaxis and early treatment per protocol.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Denosumab
- Abatacept + Denosumab Moderate
- Adalimumab + Denosumab Moderate
- Alefacept + Denosumab Moderate
- Alemtuzumab + Denosumab Moderate
- Anakinra + Denosumab Moderate
- Azacitidine + Denosumab Moderate
Other interactions of Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + Melphalan Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Melphalan Contraindicated
- Measles mumps and rubella vaccine live + Melphalan Contraindicated
- Measles mumps and rubella vaccine + Melphalan Contraindicated
- Measles mumps rubella and varicella vaccine live + Melphalan Contraindicated
Frequently asked questions
Can I take Denosumab with Melphalan?
MediHelp rates the interaction as moderate. Denosumab and Melphalan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Melphalan is strongly myelosuppressive and immunosuppressive, and denosumab labeling cautions about serious infections in immunocompromised patients. The combination can increase infection risk.
How serious is the interaction between Denosumab and Melphalan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and clinically for infection, especially during neutropenia. Use antimicrobial prophylaxis and early treatment per protocol.
What other medicines interact with Denosumab?
MediHelp also lists interactions of Denosumab with, for example, Abatacept, Adalimumab, Alefacept. The full list is on the Denosumab page.
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