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Brand names:

Alkeran®, Evomela®

Other names:

Phenylalanine Mustard; L-PAM; L-Phenylalanine Mustard; L-Sarcolysin

Often used for:

Multiple myeloma, Hodgkin lymphoma, Ovarian cancer, Conditioning for hematopoietic cell transplant

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What is Melphalan?

Melphalan is a type of chemotherapy. It works by slowing or stopping the growth of cancer cells. It may be used to help prepare patients for hematopoietic cell transplant.

Melphalan can cause tissue damage if it leaks from the vein. Patients may have irritation and skin damage at the IV site. Let a caregiver know if there is burning during administration.

Patients will have regular blood draws to check blood counts and monitor liver and kidney function.

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May be taken as a tablet by mouth

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May be given as a liquid into a vein by IV

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Possible Side Effects

  • Low blood counts (may cause increased risk of infection, bleeding, anemia and/or fatigue)
  • Nausea and vomiting
  • Loss of appetite
  • Changes in taste
  • Dizziness
  • Mouth sores
  • Fatigue or weakness
  • Hair loss
  • Diarrhea
  • Constipation
  • Skin irritation at the IV site
  • Skin rashes
  • Change in the normal menstrual cycle
  • Loss of fertility (may be temporary or permanent)
  • Kidney problems
  • Liver problems
  • Lung problems
  • Heart problems (at very high doses)

Symptoms of an allergic reaction may include: hives, rash, itching, difficulty breathing and/or swallowing, low blood pressure

Not all patients who take melphalan will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

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Possible Late Effects

Some patients may experience long-term or late effects of treatment that may continue or develop months or years after treatment ends. Possible late effects due to melphalan include:

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Tips for Families

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • A doctor may prescribe medicine to help with nausea and vomiting.
  • While taking melphalan, it is important to drink plenty of fluids. Patients should follow the care team’s instructions for appropriate fluid intake.
  • Sexually active patients should take steps to prevent pregnancy during treatment and for a period of time after completion of therapy.
  • Patients should tell their doctor if they are pregnant or breastfeeding.
  • Caregivers should follow instructions for safe handling and disposal of the medicine and avoid contact with patient body fluids, which can contain the drug for 48 hours after it is given.
  • This medication may interfere with vaccines. Ask your healthcare provider before getting vaccines while receiving this medication.

Melphalan at Home:

  • Take medicine at the same time each day. Take tablets on an empty stomach, 1 hour before or 2 hours after eating. Talk to your doctor or pharmacist if stomach upset occurs.
  • Swallow tablets whole. Do not crush or chew.
  • Caregivers should wear gloves when handling this medicine. If the medicine gets on your skin, wash the area right away.
  • Store melphalan tablets in the refrigerator. Protect from light.
  • Give a missed dose as soon as possible. If it is near the time for the next dose, skip the dose. Do not give 2 doses at the same time.
  • Do not use the medicine past the expiration date.
  • Follow instructions for safe handling and disposal.