Melphalan

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Alkeran [DSC]; Evomela; Hepzato

Brand Names: Canada

Alkeran; TARO-Melphalan

Warning

  • This drug may lower the ability of the bone marrow to make blood cells that the body needs. If blood cell counts get very low, this can lead to bleeding problems, infections, or anemia. If you have questions, talk with the doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Other types of cancer may rarely happen later in life.
  • Allergic reactions may rarely occur.

What is this drug used for?

  • It is used to treat multiple myeloma.
  • It is used to treat cancer of the ovary.
  • It may be given to your child for other reasons. Talk with the doctor.

Hepzato:

  • If your child has been given this form of this drug, talk with the doctor for information about the benefits and risks. Talk with the doctor if you have questions or concerns about giving this drug to your child.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.

If your child is breast-feeding a baby:

  • Be sure your child does not breast-feed a baby while taking this drug. Your child may also need to avoid breast-feeding a baby for some time after the last dose. Talk with your child’s doctor to see if your child needs to avoid breast-feeding a baby after the last dose.

This drug may interact with other drugs or health problems.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Your child may have more chance of getting infections. Have your child wash hands often. Avoid crowds and people with infections, colds, or flu.
  • Your child may bleed more easily. Make sure your child is careful and avoids injury. Be sure your child has a soft toothbrush.
  • Talk with the doctor before your child gets any vaccines. Use of some vaccines with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
  • If your child has an upset stomach or diarrhea, is throwing up, or decreased appetite, talk with the doctor. There may be ways to lower these side effects.
  • To help with mouth sores, have your child use a soft toothbrush or cotton swabs and rinse the mouth. Do not let your child use mouth rinses that have alcohol in them.
  • This drug may affect fertility. Fertility problems may lead to your child not being able to get pregnant or father a child later in life. This may go back to normal but sometimes it may not. Talk with your child’s doctor.

If your child has menstrual periods:

  • This drug may cause the ovaries to not work. This may also cause menstrual periods to stop. Talk with the doctor.

If your child is or may be sexually active:

  • This drug may cause harm to the unborn baby if your child takes it during pregnancy.
  • If your child is of childbearing age, a pregnancy test may need to be done before starting this drug to show that your child is NOT pregnant.
  • If your child or your child’s partner may become pregnant, birth control must be used while taking this drug and for some time after the last dose. Ask the doctor how long birth control must be used. If your child or your child’s partner gets pregnant, call the doctor right away.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of electrolyte problems like mood changes; confusion; muscle pain, cramps, or spasms; weakness; shakiness; change in balance; an abnormal heartbeat; seizures; loss of appetite; or severe upset stomach or throwing up.
  • Pale skin.
  • Chest pain or pressure or a fast heartbeat.
  • Dizziness or passing out.
  • Shortness of breath.
  • Swelling.
  • No menstrual period.
  • A skin lump or growth.
  • Blurred eyesight.
  • Some people have had lung problems with this drug. Sometimes, this has been deadly. Call your child’s doctor right away if your child has signs of lung problems like shortness of breath or other trouble breathing, cough that is new or worse, or fever.

Injection:

  • This drug may cause tissue damage if the drug leaks from the vein. Tell your child’s nurse if your child has any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your child’s body.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
  • Change in taste.
  • Mouth irritation or mouth sores.
  • Feeling tired or weak.
  • Weight loss.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

Tablets:

  • Give this drug on an empty stomach. Give at least 1 hour before or 2 hours after a meal.
  • Give this drug at the same time of day.
  • You will need to take special care when handling this drug. Check with the doctor or pharmacist to see how to handle this drug.

Injection:

  • It is given as an infusion into a vein over a period of time.
  • Other drugs may be given before this drug to help avoid side effects.

What do I do if my child misses a dose?

Tablets:

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Injection:

  • Call your doctor to find out what to do.

How do I store and/or throw out this drug?

Tablets:

  • Store in a refrigerator. Do not freeze.
  • Protect from light.

Injection:

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-12-11

Copyright

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Last Updated

Monday, December 12, 2022