Melphalan Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Melphalan Tablet (generic name: Melphalan) is an antineoplastic alkylating agent used to help treat multiple myeloma and a type of ovarian cancer that cannot be removed by surgery. It works by damaging the DNA inside cancer cells to stop them from dividing and growing. It must be used exactly as directed by a doctor experienced in chemotherapy, and it carries risks of serious side effects affecting the blood, lungs, and fertility.

What is Melphalan Tablet

Melphalan is a chemotherapy medicine that belongs to a group of anti-cancer medicines called alkylating agents. It is used to help treat certain cancers, including multiple myeloma and ovarian cancer.

Melphalan Tablet uses

• Relieves symptoms caused by multiple myeloma, a cancer of the blood
• Relieves symptoms caused by a type of ovarian cancer (epithelial carcinoma of the ovary) that cannot be removed by surgery
• The injectable form has been used along with surgery to treat malignant melanoma (a type of skin cancer)

Benefits of Melphalan Tablet

• Can help control symptoms of multiple myeloma and certain ovarian cancers
• Available as a tablet you swallow or as an injection into a vein, giving flexibility in how it is given

How Melphalan Tablet works

Melphalan works by damaging the genetic material (DNA) inside cancer cells, which stops them from dividing and growing.

Melphalan Tablet dosage

Always take this medicine exactly how your healthcare professional has told you to. Swallow the tablets whole with a little water. Do not break, crush, or chew the tablets. The tablet is usually taken on an empty stomach once a day, at around the same time every day. Taking the tablets right after food can delay and lower how much of the drug your body absorbs, so follow your doctor's instructions on timing with meals. If you miss a dose, tell your healthcare professional as soon as possible; do not double your next dose to make up for a missed one. Do not stop taking this medicine without talking to your doctor first. The injection form is given directly into a vein by a specially trained doctor or nurse.

Available forms and strengths

• Tablets, 2 mg
• Injection (freeze-dried), 50 mg/vial

Side effects of Melphalan Tablet

Common

• Low blood cell counts
• Nausea and vomiting
• Diarrhea
• Mouth ulcers or sores
• Hair loss
• Skin rash and/or itching
• Flushing
• Missed or irregular menstrual periods in women
• Reduced or stopped sperm production in men
• Muscle or back pain

Serious

• Signs of infection such as fever, chills, sore throat, or mouth ulcers
• Easy bruising or unusual bleeding (nose, gums, mouth), tiny red spots on skin
• Shortness of breath, pale skin, lips, or nail beds
• Allergic reaction: rash, hives, swelling of face/lips/tongue/throat, difficulty breathing or swallowing, fast heartbeat
• Sudden worsening shortness of breath, wheezing, tiredness, cough, fever, or painful breathing (lung problems)
• Yellowing of the eyes or skin, dark urine, abdominal pain, loss of appetite (liver problems)
• Development of new cancers other than the one being treated
• Infertility in both men and women
• Severe muscle breakdown: muscle weakness, soreness, bruising, fever, little or no urine, tea-colored urine
• Compartment syndrome at injection site: pain, pale skin, numbness, tingling, weakness or paralysis in the limb

Warnings and precautions

• This medicine should only be given by or under the supervision of a doctor experienced in using chemotherapy drugs, because of the risk of serious side effects.
• This medicine can severely lower your bone marrow's ability to make blood cells, raising the risk of infections, bleeding, and anemia.
• Rare but serious lung problems, including scarring of the lungs, have occurred and some cases have been fatal.
• This medicine can increase the risk of blood clots, especially when combined with certain other cancer medicines; your doctor may recommend blood-thinning treatment, particularly in the first several months.
• This medicine may cause new, different cancers to develop later, especially with long-term use.
• This medicine can cause infertility in both men and women, and may cause genetic damage; men are advised not to father a child during treatment and for 6 months afterward.
• Do not receive live vaccines while on this medicine without checking with your doctor, since it can weaken your immune system's ability to handle them safely.
• Melphalan has not been proven safe for an unborn baby. It should only be used in pregnancy, or in women who could become pregnant, if the benefits outweigh the possible risks, as judged by the doctor.
• Women should not breastfeed while taking melphalan, as it is not known whether the drug passes into breast milk and it could seriously harm a nursing baby.
• People with kidney disease may need a lower dose, because the drug can build up more in the body and increase the risk of serious blood cell problems.
• Tell your doctor if you have liver problems, since dose selection should be cautious in patients with reduced liver function.
• Be careful when driving or operating machinery while taking this medicine, as caution is advised.

Storage

• Store ALKERAN tablets in a refrigerator, between 2°C and 8°C
• Protect from light
• Keep out of reach and sight of children
• ALKERAN injection should be stored at controlled room temperature (15°C to 30°C) and protected from light

When to see a doctor

• Get immediate medical help for signs of an allergic reaction, such as rash, hives, swelling of the face, lips, tongue or throat, trouble swallowing or breathing, or a fast heartbeat.
• Seek medical help right away if you notice signs of infection (fever, chills, sore throat, mouth ulcers), unusual tiredness, easy bruising, or bleeding from the nose, gums, or mouth, tiny red spots on the skin, or shortness of breath.
• Get emergency help if you suddenly have worsening shortness of breath, wheezing, tiredness, a cough or fever, or painful breathing, as these could be signs of serious lung problems.
• If you think you have taken too much of this medicine, contact your healthcare professional or local emergency services right away, even if you feel fine.
• Tell your doctor right away if you develop pain, swelling, bleeding, or signs of a blood clot (such as leg pain or swelling), as treatment may need to be stopped and blood-thinning treatment started.

Alternatives

• Cyclophosphamide
• Bendamustine
• Pomalidomide