Melphalan

Melphalan treats certain types of cancer. It can cause diarrhea and hair loss. Women should not get pregnant while on melphalan.

Melphalan Overview

Updated: 

Melphalan is a prescription medication used to treat multiple myeloma (a type of cancer of the bone marrow). It may also be used to treat a certain type of ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed). Melphalan belongs to a group of drugs called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

This medication comes in tablet form and is usually take once a day, with or without food.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Common side effects nausea, vomiting, diarrhea, and mouth ulcers.

 

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  • Breast Neoplasms
  • Multiple Myeloma
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  • Ovarian Neoplasms
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Uses of Melphalan

Oral/Injectable:

Melphalan is a prescription medication used to treat multiple myeloma (a type of cancer of the bone marrow). It may also be used to treat a certain type of ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Melphalan Brand Names

Melphalan may be found in some form under the following brand names:

Melphalan Drug Class

Melphalan is part of the drug class:

Side Effects of Melphalan

Oral/Injectable:

Common side effects of melphalan include the following:

  • nausea
  • vomiting
  • diarrhea
  • mouth ulcers

This is not a complete list of melphalan side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Melphalan Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

This is not a complete list of melphalan drug interactions. Ask your doctor or pharmacist for more information.

Melphalan Precautions

Oral/Injectable:

Serious side effects have been reported with melphalan including the following:

  • lowered blood counts. This is medically known as bone marrow suppression. Your doctor may monitor for bone marrow suppression, as it can lead to thrombocytopenia, anemia, and leukopenia
    • thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets. Tell your healthcare provider right away if you have the following signs and symptoms of thrombocytopenia:
      • mild to serious bleeding
      • purple, brown, and red bruises (purpura)
      • small red or purple dots on your skin (petechiae)
      • prolonged bleeding, even from minor cuts
      • bleeding or oozing from the mouth or nose, especially nosebleeds or bleeding from brushing your teeth
      • abnormal vaginal bleeding (especially heavy menstrual flow)
      • blood in the urine or stool or bleeding from the rectum. Blood in the stool can appear as red blood or as a dark, tarry color. Taking iron supplements also can cause dark, tarry stools.
      • headaches and other neurological symptoms. These problems are very rare, but you should discuss them with your doctor.
    • anemia. This is a condition in which your blood has a lower than normal number of red blood cells. Tell your healthcare provider right away if you have the following signs and symptoms of anemia:
      • shortness of breath
      • dizziness
      • headache
      • coldness in the hands and feet
      • pale skin
      • chest pain
    • neutropenia. This is when there is an abnormally low number of white blood cells. These cells, which are called neutrophils, help the body fight infection. Those who develop neutropenia are more likely to have fevers and infections.
  • serious skin reactions such as rash or skin tissue death
  • inflammation of the blood vessels
  • hair loss
  • severe allergic reaction. Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:
    • chest pain
    • swelling of the face, eyes, lips, tongue, arms, or legs
    • difficulty breathing or swallowing
    • rash
  • pulmonary fibrosis. This is a condition in which the tissue deep in your lungs becomes scarred over time. This tissue gets thick and stiff. That makes it hard for you to catch your breath, and your blood may not get enough oxygen.
  • interstitial pneumonitis. This is when the lungs are inflamed and become scarred. The inflammation and scarring make it hard to get enough oxygen.

Do not take melphalan if you are allergic to melphalan, to any of its ingredients, or if you have experienced resistance to this medication.

Melphalan Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of melphalan, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before taking melphalan, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • tell your doctor and pharmacist if you are allergic to melphalan, any other medications, or any of the ingredients in melphalan tablets. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you have taken melphalan before, but your cancer did not respond to the medication. Your doctor will probably tell you not to take melphalan.
  • tell your doctor if you have received radiation therapy or other chemotherapy recently or if you have or have ever had kidney disease.
  • you should know that melphalan may interfere with the normal menstrual cycle (period) in women and may temporarily or permanently stop sperm production in men.
  • melphalan may cause infertility (difficulty becoming pregnant); however, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breastfeeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. Use a reliable method of birth control to prevent pregnancy. Melphalan may harm the fetus.
  • do not have any vaccinations without talking to your doctor.

 

Melphalan and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. It has been shown that use of melphalan in pregnant women caused some babies to be born with problems. However, in some serious situations, the benefit of using this medication may be greater than the risk of harm to the baby.

Melphalan and Lactation

It is not known whether this drug is excreted in human milk. Melphalan should not be given to nursing mothers.

Melphalan Usage

Take melphalan exactly as prescribed.

Oral:

  • This medication comes in tablet form and is usually take once a day, with or without food.
  • Response may be very gradual over many months; it is important that repeated courses or continuous therapy be taken since improvement may continue slowly over many months, and the maximum benefit may be missed if treatment is abandoned too soon.
     

Injectable:

  • This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

 

Melphalan Overdose

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

  • Store tablets at controlled room temperature 15° to 30°C (59° to 86°F). Protect from light.
  • Store injectable in a refrigerator, 2° to 8°C (36° to 46°F). Protect from light.
  • Keep this and all medications out of the reach.

Melphalan FDA Warning

Melphalan should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Severe bone marrow suppression with resulting infection or bleeding may occur. Controlled trials comparing intravenous (IV) to oral melphalan have shown more myelosuppression with the IV formulation. Hypersensitivity reactions, including anaphylaxis, have occurred in approximately 2% of patients who received the IV formulation. Melphalan is leukemogenic in humans. Melphalan produces chromosomal aberrations in vitro and in vivo and, therefore, should be considered potentially mutagenic in humans.