Melphalan (Generic Name)

Other Names: Alkeran®

About This Drug

Melphalan is used to treat cancer. This drug can be given by mouth or in the vein (IV).

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 48 hours. Medicines are available to stop or lessen these side effects.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Loss of appetite

Possible Side Effects (Less Common)

  • Hair loss: Hair loss is rare. You may notice your hair thinning several days after getting this drug. Often hair loss is temporary; your hair should grow back when treatment is done.
  • Changes in lung tissue may happen with large amounts of this drug. These changes may not last forever, and your lung tissue may go back to normal. Sometimes these changes may not be seen for many years. You may get a cough or have trouble catching your breath.
  • Changes in liver enzymes. Liver enzymes will be checked as needed.
  • Skin and tissue irritation. You may have redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into the nearby tissue.
  • Rash
  • Tingling or warm sensation may happen while you are getting this drug in your vein

Allergic Reactions

Allergic reactions to this drug are rare, but may happen in some patients getting the IV form of the drug.  Signs of allergic reactions to this drug may include a rash, fever, chills, dizziness, rapid or heart beat that does not feel normal (palpitations), and trouble breathing.

Treating Side Effects

  • Mouth care is very important. Your mouth care should consist of gently brushing with a very soft tooth brush and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Ask your doctor or nurse about medicine to help stop or lessen nausea and throwing up.
  • While you are getting this drug in your vein, tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion.
  • If you get a rash, do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Use effective methods of birth control during your cancer treatment. Talk to your nurse or doctor about the types of birth control that should be used.
  • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Important Information

  • If you have kidney problems your kidney function will be checked as needed.
  • If you are taking this medicine by mouth, take it on an empty stomach, at least one hour before eating or two hours after eating. Take with water and swallow the tablets whole.
  • This drug may cause an increased risk of developing a second cancer

Food and Drug Interactions

This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Blurred vision or other changes in eyesight
  • Pain in your lower back or side
  • Feeling confused or agitated
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Decreased urine
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medications
  • Heavy menstrual period that lasts longer than normal
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Extreme weakness that interferes with normal activities

Sexual Problems and Reproduction Concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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