Melphalan: High-Dose for SCT (Generic Name)

Other Names: Alkeran

About this drug

Melphalan is used to treat cancer in patients who are receiving blood or bone marrow transplant. This drug is given by mouth or intravenously (IV).

Possible side effects

  • Allergic reactions to this drug are rare, but may occur in some patients. Signs of allergic reaction are shortness of breath, wheezing, rash or itching, dizziness or lightheadedness, or palpitations (feeling your heart beat rapidly).
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression may increase your risk of infection, fatigue, and bleeding.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Nausea and vomiting
  • Diarrhea that may last for several days
  • Rash
  • Development of a secondary leukemia or another disease of the bone marrow. This effect is rare.
  • Electrolyte abnormalities. Your electrolyte levels will be monitored closely.
  • Hair loss. Most patients experience scalp and body hair loss. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Changes in lung tissue may occur with high doses of this drug. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.
  • Bladder irritation
  • Sexual problems and reproduction concerns may occur. In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause, like vaginal dryness or itching.
      • This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
      • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

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 irritate your mouth and throat.
  • Ask your doctor or nurse about medication to help prevent or lessen nausea and vomiting.
  • Use effective methods of birth control during your cancer treatment.
  • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • Speak with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.

Food and drug interactions

There are no known interactions of melphalan with food. This drug may interact with other medication. Tell your doctor and pharmacist about all of the medication and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

When to call the doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Difficulty catching your breath
  • Rash or itching, dizziness or lightheadedness, or palpitations
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than twice in one day
  • Coughing

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Painful mouth or throat that makes it difficult to eat or drink
  • Diarrhea of five or six stools in one day or diarrhea with weakness or lightheadedness
  • Nausea unrelieved by prescribed medication
  • Extreme tiredness that interferes with normal activities

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