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Melphalan (Alkeran)   

Warning: Melphalan can cause blood disorders and may lower your white blood cell counts and contribute to anemia by affecting your bone marrow function. Improper or deficient bone marrow function can result in a decreased ability to fight off infections and sicknesses and may result in an increased risk of bleeding.

Melphalan may increase your risk of developing certain cancers such as leukemia and carcinoma.

Melphalan may cause birth defects and should not be taken if you are pregnant or breastfeeding or if you plan on becoming pregnant. Precautions should be taken so that you do not become pregnant while taking this medication.

Indications:  Melphalan belongs to a class of drugs known as alkylating agents and works by interfering with the growth and spread of various cancer cells throughout the body. This medication is used for different types of cancer, including (but not limited to) multiple myeloma (blood cancer), breast cancer, and ovarian cancer. Some minor side effects of this medication may include nausea, vomiting, diarrhea, itchy skin and skin rash, sores or white patches on the inside of your lips or nose, and temporary hair loss. If you experience these side effects or more severe side effects, notify your physician.

Dosage: This medication should be taken orally and is normally taken with a large glass of water, but your doctor may give you instructions to take Melphalan on an empty stomach. Your doctor will give you specific instructions regarding dosage amounts and these instructions should be followed very carefully. Your doctor will administer dosage instructions based on your current health condition, your blood cell count, and your response to treatments. Your doctor might even change your dosage instructions at various times based on how you are responding to treatment, so it is very important that you follow your doctor’s instructions carefully to get the best results from this medication and to avoid adverse reactions. Melphalan tablets should be stored in your refrigerator and away from excess light.

Mechanism of Action (MOA) – Melphalan damages cancer cells by forming cross-linkages between DNA strands (deoxyribonucleic acid), which thereby inhibiting the replication of tumor cells.

Contraindications: Do not take Melphalan without consulting with your physician if you are allergic to Melphalan, Chlorambucil, or any components of the Melphalan formulation.

The medication is not recommended in the following conditions: 

  • breastfeeding is not recommended while taking Alkeran  
  • Pregnancy  - using Melphalan is not recommended during pregnancy, especially during the first quarter; the drug may cause problems which can be harmful to the fetus  
  • Elderly, infants and children are treated with Melphalan under strict medical supervision.  

If you have one of the following medical conditions, it is important to report them to your health care provider before beginning an Melphalan treatment: 

  • lactase deficiency   
  • kidney problems  
  • fructose intolerance   
  • galactosemia  
  • glucose-galactose malabsorption  
  • You have been treated with radiotherapy or antineoplastic agents during the previous 3 weeks.   

Interactions: To avoid negative drug interactions, you should inform your doctor if you are taking any treatments or medications that affect your immune system, such as radiation therapy, cyclosporine, chemotherapy, and any other medications that you are currently taking. There are many drugs that may interact with Melphalan, so it is important that you inform your doctor of all medications that you are currently taking or that you plan on taking.

Side effects  : Melphalan attack not only cancer cells but healthy cells that multiply quickly, which often leads to adverse effects. The most common Melphalan side effects include: 

  • fatigue
  • loss of appetite
  • loss of weight
  • hair loss
  • weakness
  • nausea and vomiting
  • rash and itching
  • increased risk of bleeding
  • Pulmonary fibrosis (rare)
  • Mouth blistering, sometimes inflammation of the mouth 

See your doctor immediately if you experience any of the following symptoms:  

  • fever
  • dizziness
  • chills
  • sore throat
  • green, black, tarry stools
  • red urine or blood in urine
  • persistent cough
  • missed menstrual periods
  • sudden low or high blood pressure
  • yellowing of the skin or eyes
  • increased risk of infection
  • Difficulty breathing or shortness of breath 
  • severe clinical depression symptoms