Ivra Side Effects

Generic name: melphalan

Medically reviewed by Drugs.com. Last updated on Nov 2, 2024.

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

Applies to melphalan: powder for solution.

Other dosage forms:

• oral tablet

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before receiving this medicine. Use an effective form of birth control while you are receiving this medicine and for at least 6 months after the last dose to keep from getting pregnant. Males who are receiving this medicine, with female partners who can become pregnant, must use effective birth control during and for at least 3 months after the last dose of this medicine. If you think you have become pregnant while receiving the medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hives, hoarseness, lightheadedness or fainting, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are receiving this medicine.

This medicine may cause bleeding problems. Check with your doctor right away if you have bleeding gums, coughing up blood, difficulty in breathing or swallowing, dizziness, headache, increased menstrual flow or vaginal bleeding, nosebleeds, paralysis, prolonged bleeding from cuts, red or dark brown urine, or red or black, tarry stools.

Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, severe headache, slurred speech, sudden, unexplained trouble breathing, sudden loss of coordination, sudden, severe weakness or numbness in the arm or leg, or vision changes. These may be symptoms of blood clots (eg, thromboembolism).

Melphalan can temporarily lower the number of white blood cells in your blood, 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 the 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.

While you are being treated with melphalan (the active ingredient contained in Ivra), and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Melphalan may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Melphalan can cause diarrhea, nausea or vomiting, or sores or ulcers in the mouth, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about ways to control these symptoms.

Using this medicine may increase your risk of getting other types of cancer (eg, myeloproliferative syndrome, acute leukemia, and carcinoma). Talk to your doctor if you have concerns about this risk.

Tell your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Some men and women using this medicine have become infertile (unable to have children). This medicine might make a woman stop having menstrual periods temporarily. Talk with your doctor if this is a concern.

Serious side effects of Ivra

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 or nurse immediately if any of the following side effects occur while taking melphalan:

Other side effects of Ivra

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:

See also:

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]

Frequently asked questions

• How Does Chemotherapy Work for Multiple Myeloma?

Further information

Ivra 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