Melphalan

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

Melphalan should only be used under the supervision of a doctor experienced with the use of cancer medicines. Melphalan 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).


Melphalan 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.

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

Do NOT use melphalan if:

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

Some medical conditions may interact with melphalan. 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 melphalan. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Cisplatin because the risk of melphalan'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 melphalan 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 melphalan:

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

  • Melphalan is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using melphalan at home, a health care provider will teach you how to use it. Be sure you understand how to use melphalan. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use melphalan if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • If you spill melphalan on your skin, wash it off right away with soap and water. Clean any areas (tables, counters) where melphalan 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 melphalan, contact your doctor immediately.

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

Important safety information:

  • Melphalan 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 melphalan. Talk with your doctor before you receive any vaccine.
  • Melphalan 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 melphalan may increase your risk of developing another type of cancer. The risk may be greater if you use higher doses of melphalan or if you use it for a longer period of time. Discuss any questions or concerns with your doctor.
  • Melphalan 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.
  • Melphalan 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 melphalan. These tests may be used to monitor your condition or to check for side effects. Be sure to keep all doctor and lab appointments.
  • Melphalan should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Melphalan has been shown to cause harm to the fetus. Avoid becoming pregnant while taking melphalan. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using melphalan while you are pregnant. It is unknown if melphalan is found in breast milk. Do not breast-feed while taking melphalan.

Possible side effects of melphalan:

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 melphalan:

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

General information:

  • If you have any questions about melphalan, please talk with your doctor, pharmacist, or other health care provider.
  • Melphalan 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 melphalan 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 melphalan. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to melphalan. 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 melphalan.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
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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