Evomela Side Effects

Generic name: melphalan

Medically reviewed by Drugs.com. Last updated on Mar 23, 2025.

Note: This document provides detailed information about Evomela Side Effects associated with melphalan. Some dosage forms listed on this page may not apply specifically to the brand name Evomela.

Applies to melphalan: oral tablet.

Other dosage forms:

• powder for solution

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with melphalan (the active ingredient contained in Evomela) and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Melphalan may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take or should not have taken oral polio vaccine within the last several months since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Melphalan can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Along with their needed effects, medicines like melphalan can sometimes cause unwanted effects such as blood problems and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Serious side effects of Evomela

Along with its needed effects, melphalan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking melphalan:

Other side effects of Evomela

Some side effects of melphalan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to melphalan: injectable powder for injection, intravenous powder for injection, intravenous solution, oral tablet.

Hematologic adverse events

• Rare (less than 0.1%): Hemolytic anemia^[Ref]

thrombocytopenia, anemia)

Oncologic

• Frequency not reported: Secondary malignancies (e.g., acute nonlymphocytic leukemia, myeloproliferative syndrome, carcinoma^[Ref]

Respiratory

• Rare (less than 0.1%): Interstitial pneumonitis, pulmonary fibrosis
• Frequency not reported: Bronchospasm, dyspnea^[Ref]

Dermatologic

• Very common (10% or more): Alopecia (at high dose)
• Common (1% to 10%): Alopecia (at conventional dose)
• Rare (less than 0.1%): Maculopapular rash, pruritus
• Frequency not reported: Skin hypersensitivity, skin necrosis (rarely requiring skin grafting)^[Ref]

Cardiovascular

• Frequency not reported: Tachycardia, hypotension, vasculitis^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea, vomiting, diarrhea, stomatitis (at high dose)
• Rare (less than 0.1%): Stomatitis (at conventional dose)^[Ref]

Hepatic

• Rare (less than 0.1%): Abnormal liver function tests to clinical manifestations such as hepatitis and jaundice; veno-occlusive disease following high dose treatment^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Allergic reactions (e.g., urticaria, edema, skin rashes, anaphylactic shock)^[Ref]

Other

• Very common (10% or more): Warmth, tingling
• Frequency not reported: Chromosome damage^[Ref]

Renal

• Common (1% to 10%): Temporary significant elevation of the blood urea has been seen in the early stages of therapy with this drug in myeloma patients with renal damage^[Ref]

Local

• Frequency not reported: Skin ulceration at injection site^[Ref]

Musculoskeletal

• Very common (10% or more): Muscle atrophy, muscle fibrosis, myalgia, blood creatine phosphokinase increased
• Common (1% to 10%): Compartment syndrome
• Frequency not reported: Muscle necrosis, rhabdomyolysis^[Ref]

See also:

Further information

Evomela side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer