DrugindexOnline^{2nd edition}

Generic Name: Melphalan Injection (MEHL-fuh-lan)
Brand Name: Alkeran

Melphalan should only be used under the supervision of a doctor experienced with the use of cancer medicines. Melphalan may cause a decrease in the body's blood cells (bone marrow suppression), which could cause bleeding problems or infection. It may also cause blood cell cancer (eg, leukemia). Notify your doctor immediately if you develop easy bleeding or bruising, unusual fatigue, rash, hives, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue, or signs of an infection, such as persistent sore throat or fever while using Melphalan .

Melphalan is used for:

Treating certain types of cancer.

Melphalan is an alkylating agent. It works by destroying resting and rapidly dividing tumor cells in certain types of cancer.

Do NOT use Melphalan if:

• you are allergic to any ingredient in Melphalan
• you have used Melphalan before and it did not work
• you are taking nalidixic acid

Contact your doctor or health care provider right away if any of these apply to you.

Before using Melphalan :

Some medical conditions may interact with Melphalan . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you are a female of childbearing age
• if you have bone marrow depression, an infection, low white blood cell count, kidney problems, shingles, or chickenpox, or are undergoing radiation therapy

Some MEDICINES MAY INTERACT with Melphalan . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Cisplatin because the actions and side effects of Melphalan may be increased
• Carmustine (BCNU), cyclosporine, or nalidixic acid because serious lung, kidney, or intestinal problems may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Melphalan may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Melphalan :

Use Melphalan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Melphalan is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Melphalan at home, carefully follow the injection procedures taught to you by your health care provider.
• If Melphalan contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Use Melphalan as soon as it is mixed. Do not keep Melphalan after it has been mixed. Any leftover medicine or supplies used with Melphalan should be placed in a plastic bag and disposed of as instructed by your doctor, nurse, or pharmacist.
• If Melphalan accidentally spills on your skin, wash it off immediately with soap and water. Clean any areas (tables, counters) where Melphalan may have spilled or sprayed.
• Keep this product, as well as syringes and needles, out of the reach of children. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for proper disposal.
• If you miss a dose of Melphalan , contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Melphalan .

Important safety information:

• If nausea, vomiting, or loss of appetite occurs, ask you doctor or pharmacist for ways to lessen these effects.
• Melphalan may lower your body's ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection including fever, sore throat, rash, or chills.
• Check with your doctor before having vaccinations while you are using Melphalan .
• Melphalan may reduce the number of blood cells that are needed for clotting. To prevent bleeding, avoid situations where bruising or injury may occur.
• LAB TESTS, including complete blood cell counts, may be necessary to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
• Use Melphalan with extreme caution in CHILDREN; safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Melphalan has been shown to cause harm to the fetus. Avoid becoming pregnant while taking Melphalan . If you think you may be pregnant, discuss with your doctor the benefits and risks of using Melphalan during pregnancy. It is unknown if Melphalan is excreted in breast milk. Do not breast-feed while taking Melphalan .

Possible side effects of Melphalan :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; hair loss; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in urine or stools; dark urine; diarrhea; fatigue; fever or chills; irregular or absent menstrual periods; joint pain; lower back or side pain; persistent cough; persistent nausea or vomiting; sore throat; sores on the mouth or lips; stomach pain; swollen feet or lower legs; unusual bruising or bleeding; unusual lumps or growths; unusual tiredness; weight loss; yellowing eyes and skin.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include diarrhea; drowsiness; intestinal bleeding; paralysis; seizures; severe nausea and vomiting.

Proper storage of Melphalan :

Store Melphalan at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Melphalan out of the reach of children and away from pets.

General information:

• If you have any questions about Melphalan , please talk with your doctor, pharmacist, or other health care provider.
• Melphalan is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Melphalan . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.