Melphalan (patient information)

# IMPORTANT WARNING
Melphalan can cause a decrease in the number of blood cells in your bone marrow. Your doctor will order tests before, during, and after your treatment to see if your blood cells are affected by this drug.
Melphalan has been associated with the development of other types of cancers. Talk with your doctor about the potential risk of developing a new cancer.

# About your treatment
Your doctor has ordered the drug melphalan to help treat your illness. The drug can be taken as tablets by mouth on an empty stomach or it can be given by injection into a vein.
This medication is used to treat:
- multiple myeloma
- ovarian carcinoma
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Melphalan is in a class of drugs known as alkylating agents; it slows or stops the growth of cancer cells in your body. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

# Other uses for this medicine
Melphalan is also used in the treatment of breast cancer, polycythemia vera, amyloidosis, scleromyxedema, chronic myelogenous leukemia, osteogenic sarcoma, advanced prostatic carcinoma, and testicular seminoma. Talk to your doctor about the possible risks of using this drug for your condition.

# Precautions
Before taking melphalan:
- tell your doctor and pharmacist if you are allergic to melphalan, chlorambucil (Leukeran), or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin and vitamins.
- you should know that melphalan may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Melphalan may harm the fetus.
- do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

# Side effects

## Minor side effects
Side effects from melphalan are common and include:
- loss of appetite or weight
- weakness
- blistering skin or acne
Tell your doctor if either of these symptoms is severe or lasts for several hours:
- mouth blistering
- fatigue

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- unusual bruising or bleeding
- black, tarry stools
- red urine
- cough
- sore throat
- congestion
- difficulty breathing
- fever
- dizziness
- chills
- shortness of breath
- rash or itching
- nausea and vomiting
- missed menstrual periods
- yellowing of the skin or eyes
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions
Keep melphalan in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Special instructions
Drink plenty of fluids and urinate frequently during your treatment.

# Brand names
- Alkeran

# Other names
- L-PAM