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Melphalan (oral/injection)

Generic name: melphalan (oral/injection) [MEL-fa-lan] Brand names: Alkeran, Alkeran I.V., and Evomela
Dosage Forms: intravenous injection powder (50 mg) or oral tablet (2mg)
Drug class: alkylating agents

What is Melphalan?

Melphalan can be used to treat multiple myeloma, a form of blood cancer. It may also relieve the symptoms of ovarian cancer. Melphalan is used to "condition" the body before a stem-cell transplant. Melphalan can be used in other ways not mentioned in this guide.

Side effects of Melphalan

If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives or itchiness, redness of skin, blurred vision, lightheadedness, rapid heartbeats, difficulty breathing, swelling of the face, lips, tongue, or throat.

Melphalan may cause serious side effects. If you experience:

  • Low white blood cells—fever and chills—cough, burning, or pain when you urinate
  • Low red blood cells, or anemia, can cause pale skin, unusual fatigue, feeling lightheaded, shortness of breath, and cold hands and/or feet.
  • Easy bruising, unusual bleeding, or purple or red patches under the skin
  • Dry mouth; bad breath;
  • Severe nausea or vomiting
  • New or worsening cough; fever; difficulty breathing
  • Unusual lumps and masses
  • Missed menstrual cycles
  • Inflammation of your blood vessels—warmth, tingling, or skin rash; headaches, body aches, and sweats; weight gain; feeling weak or tired.
  • Liver problems: loss of appetite; pain in the upper right corner of the stomach; dark urine; clay-colored stools; jaundice (yellowing skin or eyes);
  • Constipation. Leg cramps.

Melphalan can cause a variety of side effects.

  • Low blood cell count
  • Mouth sores;
  • Tiredness;
  • Low potassium levels
  • Hairloss.

There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.

Similar/related drugs

Blenrep, Tecvayli, Carvykti, Xpovio, Kyprolis, Elrexfio, and Talvey

Warnings

You may be more susceptible to infections, including serious or deadly ones, while using melphalan. Contact your doctor immediately if you experience a fever or chills, a cough or mouth sores, or unusual bleeding, bruising, or pain when urinating.

Before you take this drug

Melphalan should not be used if it is allergic or if it has not worked in the past.

Tell your doctor whether you have:

  • Nausea, vomiting, or diarrhea;
  • An infection, or a weak immune system caused by disease (or by taking certain medicines);
  • Liver or kidney disease
  • Radiation or chemotherapy?

Melphalan can increase your risk for other cancers, such as leukemia. This is something you should discuss with your doctor. Melphalan may harm or cause birth defects in an unborn child if either the mother or father uses this medication. After your last dose, ask your doctor for the recommended time period to continue using birth control. If you become pregnant while using melphalan, either as a mother or father, tell your doctor immediately. Both men and women may be affected by this medicine. It is still important to use birth control to avoid pregnancy, as melphalan may harm the unborn child. Melphalan should not be used while breastfeeding.

How to take Melphalan?

Review all instructions or guides included with your medication and follow them exactly. Follow the directions on the label. Melphalan oral can be taken orally. Melphalan is infused through an intravenous line (IV) placed in a large vein. An injection will be administered by a healthcare provider.The infusion of this medicine can take 30 minutes. If you experience any pain or swelling when the IV needle is inserted, tell your caregivers. Melphalan is given as a palliative for multiple myeloma. It's usually administered every 2 to 4 weeks. Melphalan is taken orally daily. Your doctor may ask you to temporarily stop taking the medication. Melphalan is given as a conditioning treatment for stem cell transplantation. It's usually given two days straight before the transplant. Melphalan is taken orally for 5 consecutive days every 4 to 5 weeks as a palliative for ovarian carcinoma. Do not forget to follow your doctor's instructions.

Another medication may be prescribed to prevent nausea. Continue to use this medication and inform your doctor if severe nausea, vomiting, or diarrhea occurs. You will be required to test your blood frequently. Your doctor can then determine the right dose for you. The results of your blood test may delay cancer treatment. You could get serious or even fatal infections. You will need to be examined by your doctor on a regular schedule. Melphalan may take several weeks before your body begins to respond. Your doctor will decide for how long you should take this medication. For best results, keep using melphalan as directed. If you stop taking this medication too soon, you may not receive the full benefits. Keep the melphalan tablet away from light and in the fridge.

What happens if I miss the dose?

If you are almost due for your next dose, skip the missed one. Never take two doses of a medicine at the same time. If you are unable to attend your appointment, call your doctor and ask for instructions.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention. Overdose symptoms include severe weakness, vision issues, severe mouth sores or blisters, increased sweating or salivation, shortness of breath, and severe nausea or vomiting. Other symptoms can be severe stomach pain or diarrhea, bleeding or tarry stool, seizures, and severe nausea or vomiting.

What should be avoided?

Avoid receiving a "live vaccine" while taking melphalan. As it may not provide as effective protection, and may not function optimally, vaccination may not offer adequate defenses against disease.Live vaccines are available for measles (MMR), rubella, mumps (R), typhoid (chickenpox), varicella, zoster, and influenza (nasal flu). Avoid being around people who are sick or infected to reduce the chance of infection spreading further. If you notice any signs of an infection, tell your doctor immediately. Avoid any activities that could increase your risk of injury or bleeding. Take extra precautions to avoid bleeding when shaving or brushing your teeth.

Interaction with other drug

Melphalan can be affected by other drugs, such as vitamins and herbal supplements. Inform your doctor of all the medicines you are taking and those that you stop or start using.