Melphalan (Generic Name)
Other Names: Alkeran
About This Drug
Melphalan is used to treat cancer. This drug is given orally 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, 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 usually occurs 14 to 21 days after the drug is given and 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.
- Loss of appetite
- Nausea and vomiting
- Hair loss is rare. You may notice hair thinning several days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
- Skin and tissue irritation. You may have redness, pain, warmth, or swelling at the IV site. This irritation occurs if the drug leaks out of the vein and into surrounding tissue.
- Lung tissue changes may occur but are rare. These changes may not be permanent; your lung tissue may return to normal. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.
- A secondary leukemia or another disease of the bone marrow may develop.
- If you have kidney problems (renal insufficiency), your kidney function will be checked as needed.
- Darkening of skin. This is usually temporary and should fade when treatment is completed.
- Chest pain
- Rapid or irregular heartbeat (palpitations)
- Changes in liver enzymes. Liver enzymes will be checked as needed.
- 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 effect 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.
- Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
- Be careful when cooking, walking, and handling sharp objects and hot liquids.
- 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.
Food and Drug Interactions
Food may prevent your body from absorbing oral melphalan. Take this drug one hour before or two hours after meals. This drug may interact with other medications. Tell your doctor and pharmacist all the medications that you are currently taking.
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
- 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
- Redness, pain, warmth, or swelling at the IV site
- Chest pain
- Rapid or irregular heartbeat
- Urgent need to urinate
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 for you to eat or drink
- Nausea unrelieved by prescribed medication
- Urinating in smaller amounts than usual
- Persistent loss of appetite or weight loss of five pounds or more in one week
- Extreme tiredness that interferes with normal activities
- Rash that is bothersome