Melphalan can cause a severe decrease in the number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; bloody vomit; or vomiting blood or brown material that resembles coffee grounds.
Keep all appointments with your doctor and the laboratory. Your doctor will order laboratory tests regularly before and during your treatment to see if your blood cells are affected by this drug.
Melphalan may increase the risk that you will develop other cancers. Talk with your doctor about the risks of taking melphalan.
The basics
Melphalan (brand name- Alkeran) is an FDA-approved treatment for multiple myeloma (a type of cancer of the bone marrow). It is also useful to treat a certain type of ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed).
Melphalan falls in a class of alkylating agents medications. It works by stopping or slowing the growth of cancer cells in your body.
Let us walk you through the key things you need to know about Melphalan.
How should I take melphalan (Alkeran)?
Melphalan comes as a tablet to take by mouth. It is usually taken on an empty stomach once a day. Take melphalan at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take melphalan exactly as directed. Do not take more or less of it or take it more often than prescribed by your Doctor.
Talk to your doctor about how you are feeling during your treatment. Do not stop taking melphalan without talking to your doctor.
Do not stop taking melphalan without talking to your Doctor. You can help them by tracking your side effects in Ankr.
What are the side effects of melphalan (Alkeran)?
Common side effects
- nausea
- vomiting (emesis)
- appetite loss (anorexia)
- abnormal weight loss
- throa sores
- mucositis (mouth sore)
- missed menstrual periods (in girls and women)
- joint, muscle, or back pain
- rash
- hives
- excessive itching (pruritus)
Serious side effects
- difficulty breathing
- dysphagia (painful swallowing)
- pale skin
- excessive tiredness
- fainting (syncope)
- fast, irregular, or pounding heartbeat
- yellowing of the skin or eyes
- pain in the upper right part of the stomach
- dark colored urine
- unusual lumps or masses
Melphalan may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088).
Use the free Ankr platform or Ankr app to track your symptoms.
What special precautions should I follow?
Before taking melphalan or Alkeran
- tell your doctor about your allergies
- tell your doctor about other intakes
- tell your doctor if you have or ever had any other disease, symptom, or treatment
- tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are receiving melphalan. Talk to your Doctor about birth control methods that will work for you
While you are on melphalan or Alkeran
- if you become pregnant while receiving melphalan, call your Doctor immediately. Melphalan may harm the fetus
- tell your Doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking melphalan
- do not have any vaccinations without talking to your Doctor
I forgot a dose. What should I do?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
In case of an emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- vomiting (emesis)
- diarrhea (loose stools)
- sores in the mouth and throat
- black, tarry, or bloody stools
- bloody vomit or vomited material that looks like coffee grounds
- unusual bruising or bleeding
- sore throat, cough, fever, or other signs of infection
How should I safely store and dispose of melphalan (Alkeran) ?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it in the refrigerator and away from light.
You should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
Brand names
- Alkeran® Tablets
Other names
- Phenylalanine mustard
Last Revised – 06/18/2023, FDA updated- 05/15/2017, SG
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