melphalan

(mel FAH lan)
Alkeran, Alkeran I.V.

What is the most important information I should know about melphalan?

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Melphalan should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

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Serious side effects have been reported with the use of melphalan including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; fever or chills; or signs of infection such as fever; chills, or sore throat); lung problems; severe nausea, vomiting, diarrhea, and loss of appetite; and others. Talk to your doctor about the possible side effects from treatment with melphalan.

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In some cases, second cancers have been reported to occur during and following treatment with melphalan. Talk to your doctor about the risks and benefits of this medication.

What is melphalan?

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Melphalan is a cancer (antineoplastic) medication. Melphalan interferes with the growth of cancer cells and slows their growth and spread in the body.

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Melphalan is used to treat multiple myeloma (a type of blood cancer), cancer of the ovary, and breast cancer.

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Melphalan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking melphalan?

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Before taking melphalan, tell your doctor if you have

kidney disease; or

have bone marrow problems.

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You may not be able to take melphalan, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

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Melphalan is in the FDA pregnancy category D. This means that melphalan is known to cause birth defects in an unborn baby. Do not take melphalan without first talking to your doctor if you are pregnant or could become pregnant during treatment. Contraceptive measures are recommended during treatment with melphalan.

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It is not known whether melphalan passes into breast milk. Do not take melphalan without first talking to your doctor if you are breast feeding a baby.

How should I take melphalan?

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Take melphalan exactly as directed by your doctor. If you do not understand these instructions, as your doctor, nurse or pharmacist to explain them to you.

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Take each oral dose with a large glass of water.

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Injectable melphalan should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

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Your doctor will determine the correct amount and frequency of treatment with melphalan depending upon the type of cancer being treated and other factors. Talk to your doctor if you have any questions or concerns regarding the treatment schedule.

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Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with melphalan to monitor progress and side effects.

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Store melphalan tablets at room temperature away from heat and moisture. Keep this product out of the reach of children.

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Your healthcare provider will store melphalan injection as directed by the manufacturer. If you are storing melphalan injection at home, follow the directions provided by your healthcare provider. Melphalan injection requires special disposal and should not be thrown out with regular trash.

What happens if I miss a dose?

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Contact your doctor if you miss a dose of melphalan.

What happens if I overdose?

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If for any reason an overdose of melphalan is suspected, seek emergency medical attention or contact your healthcare provider immediately.

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Symptoms of a melphalan overdose tend to be similar to side effects caused by the medication, although often more severe.

What should I avoid while taking melphalan?

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Melphalan can lower the activity of your immune system making you susceptible to infections. Avoid contact with people who have colds, the flu, or other contagious illnesses and do not receive vaccines that contain live strains of a virus (e.g., live oral polio vaccine) during treatment with melphalan. In addition, avoid contact with individuals who have recently been vaccinated with a live vaccine. There is a chance that the virus can be passed on to you.

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Skin accidentally exposed to melphalan injection should be rinsed thoroughly with soap and warm water.

What are the possible side effects of melphalan?

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If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; or fever, chills, or signs of infection);

red or irritated blood vessels (veins);

severe nausea, vomiting or weight loss;

difficulty breathing or a persistent cough; or

unusual lumps or masses.

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Other less serious side effects may be more likely to occur. Talk to your doctor if you experience

temporary hair loss;

itching and rash;

lack of menstruation in women;

mild to moderate nausea, vomiting, or diarrhea; or

sores in the mouth.

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In some cases, second cancers have been reported to occur during and following treatment with melphalan. Talk to your doctor about the risks and benefits of this medication.

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Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect melphalan?

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Before taking melphalan, tell your doctor if you are taking any other medicines, especially any of the following:

cyclosporine (Gengraf, Neoral, Sandimmune);

cisplatin (Platinol, Platinol-AQ);

carmustine (BiCNU, Gliadel);

nalidixic acid (Neggram); or

another chemotherapy medicine.

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You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

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Do not receive "live" vaccines during treatment with melphalan. Administration of a live vaccine may be dangerous during treatment with melphalan.

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Drugs other than those listed here may also interact with melphalan. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, during treatment with melphalan.

Where can I get more information?

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Your pharmacist has additional information about melphalan written for health professionals that you may read.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.