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Alkeran

Generic Name: melphalan (MEL-fa-lan)
Brand Name: Alkeran

Alkeran should only be used under the supervision of a doctor experienced with the use of cancer medicines. Alkeran may cause a decrease in the body's blood cells (bone marrow suppression), which could cause bleeding problems or infection. It may also cause a certain type of blood cell cancer (leukemia) or a severe allergic reaction. Notify your doctor immediately if you develop unusual bleeding or bruising, unusual fatigue, symptoms of an allergic reaction (eg, rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue), or signs of an infection (eg, fever, chills, persistent sore throat).


Alkeran is used for:

Treating symptoms of a certain type of cancer (multiple myeloma). It may also be used for other conditions as determined by your doctor.

Alkeran is an alkylating agent. It works by destroying resting and rapidly dividing tumor cells in certain types of cancer.

Do NOT use Alkeran if:

  • you are allergic to any ingredient in Alkeran
  • you have used Alkeran before and it did not work
  • you have taken or will be taking palifermin within 24 hours before or after using Alkeran
  • you are taking nalidixic acid

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using Alkeran:

Some medical conditions may interact with Alkeran. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are a female of childbearing age
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have bone marrow problems, low white blood cell count, low platelet count, an infection, kidney problems, shingles, or chickenpox
  • if you have had chemotherapy or radiation treatment
  • if you have recently had or are scheduled to have a vaccine

Some MEDICINES MAY INTERACT with Alkeran. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Cisplatin because the risk of Alkeran's side effects may be increased
  • Carmustine (BCNU), cyclosporine, or nalidixic acid because serious lung, kidney, or bowel problems may occur
  • Palifermin because if mouth or tongue sores develop, they may be more severe or last longer

This may not be a complete list of all interactions that may occur. Ask your health care provider if Alkeran may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Alkeran:

Use Alkeran as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Alkeran is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Alkeran at home, a health care provider will teach you how to use it. Be sure you understand how to use Alkeran. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use Alkeran if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • If you spill Alkeran on your skin, wash it off right away with soap and water. Clean any areas (tables, counters) where Alkeran may have spilled or sprayed.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of Alkeran, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Alkeran.

Important safety information:

  • Alkeran may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Do not receive a live vaccine (eg, measles, mumps) while you are taking Alkeran. Talk with your doctor before you receive any vaccine.
  • Alkeran may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • If nausea, vomiting, or loss of appetite occurs, ask your doctor or pharmacist for ways to lessen these effects.
  • Use of Alkeran may increase your risk of developing another type of cancer. The risk may be greater if you use higher doses of Alkeran or if you use it for a longer period of time. Discuss any questions or concerns with your doctor.
  • Alkeran may affect the ovaries. This may cause irregular or absent menstrual periods and decreased fertility in some women. Discuss any questions or concerns with your doctor.
  • Alkeran may affect the testicles and cause decreased fertility in some men. This may be permanent in some patients. Discuss any questions or concerns with your doctor.
  • Lab tests, including complete blood cell counts, may be performed while you use Alkeran. These tests may be used to monitor your condition or to check for side effects. Be sure to keep all doctor and lab appointments.
  • Alkeran should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Alkeran has been shown to cause harm to the fetus. Avoid becoming pregnant while taking Alkeran. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Alkeran while you are pregnant. It is unknown if Alkeran is found in breast milk. Do not breast-feed while taking Alkeran.

Possible side effects of Alkeran:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; hair loss; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in urine or stools; chest pain; dark urine; dizziness or light-headedness; fainting; fast heartbeat; fatigue; fever or chills; irregular or absent menstrual periods; numbness of an arm or leg; pain, swelling, or redness at the injection site; pale stools; persistent cough; persistent loss of appetite; severe or persistent diarrhea, nausea, or vomiting; shortness of breath; sore throat; sores on the mouth, tongue, or lips; stomach pain; sudden, severe headache; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual lumps or growths; unusual tiredness or weakness; weight loss; yellowing eyes and skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include decreased urination; diarrhea; paralysis; seizures; severe drowsiness; severe nausea and vomiting; sores on the mouth, tongue, or lips; symptoms of stomach or bowel bleeding (eg, black, tarry, or bloody stools; vomit that looks like coffee grounds); trouble breathing.

Proper storage of Alkeran:

Alkeran is usually handled and stored by a health care provider. If you are using Alkeran at home, store Alkeran as directed by your pharmacist or health care provider. Keep Alkeran out of the reach of children and away from pets.

General information:

  • If you have any questions about Alkeran, please talk with your doctor, pharmacist, or other health care provider.
  • Alkeran is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Alkeran or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Alkeran. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Alkeran. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Alkeran.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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