Health Guide
Drug Guide

Melphalan (Intravenous route)

Pronunciation:

MEL-fa-lan

Brand Names:

Dosage Forms:

Warnings:

Intravenous route(Powder for Solution)

Alkeran(R): Melphalan should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Severe bone marrow suppression with resulting infection or bleeding may occur. Controlled trials comparing intravenous (IV) to oral melphalan have shown more myelosuppression with the IV formulation. Hypersensitivity reactions, including anaphylaxis, have occurred in approximately 2% of patients who received the IV formulation. Melphalan is leukemogenic in humans. Melphalan produces chromosomal aberrations in vitro and in vivo and, therefore, should be considered potentially mutagenic in humans

Intravenous route(Powder for Solution)

Evomela(TM): Severe bone marrow suppression with resulting infection or bleeding may occur. Controlled trials have shown more myelosuppression with the IV formulation than the oral formulation. Monitor hematologic laboratory parameters. Hypersensitivity reactions, including anaphylaxis, have occurred in patients who received the IV formulation of melphalan hydrochloride. Discontinue treatment with melphalan hydrochloride for serious hypersensitivity reactions. Melphalan produces chromosomal aberrations in vitro and in vivo. Melphalan hydrochloride should be considered potentially leukemogenic in humans .

Classifications:

Therapeutic

Antineoplastic Agent

Pharmacologic

Alkylating Agent

Chemical

Nitrogen Mustard

Uses of This Medicine:

Melphalan injection is used to treat multiple myeloma (bone marrow cancer) and as a conditioning treatment before a bone marrow transplantation procedure in patients with multiple myeloma. Melphalan belongs to the group of medicines called alkylating agents (cancer medicines). It works by interfering with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal cells may also be affected by melphalan, other unwanted effects will also occur. Before you begin treatment with melphalan, talk to your doctor about the benefits as well as the risks of using it.

This medicine is to be given only by or under the direct supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, melphalan is used in certain patients with the following medical conditions:

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Appropriate studies have not been performed on the relationship of age to the effects of melphalan injection in the pediatric population. Safety and efficacy have not been established.

Older adults

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of melphalan injection in the elderly.

Breast-feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

You will receive this medicine in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

This medicine should come with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control during and after treatment to keep from getting pregnant. Men should also use effective contraception to prevent pregnancy in a sexual partner during and after treatment. If you think a pregnancy has occurred with this medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hives, hoarseness, lightheadedness or fainting, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are receiving this medicine.

Melphalan can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

While you are being treated with melphalan, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Melphalan may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Melphalan can cause diarrhea, nausea or vomiting, or sores or ulcers in the mouth, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about ways to control these symptoms.

Tell your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Using this medicine may increase your risk of getting other types of cancer. Talk to your doctor if you have concerns about this risk.

Some men and women using this medicine have become infertile (unable to have children). This medicine might make a woman stop having menstrual periods temporarily. Talk with your doctor if this is a concern.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Chest pain
chills
cough or hoarseness
fever
lower back or side pain
painful or difficult urination
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
Abdominal or stomach pain
absent, missed, or irregular menstrual periods
back or leg pains
bleeding gums
bloated abdomen or stomach
blurred vision
clay-colored stools
confusion
dark urine
difficult or labored breathing
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, or irregular heartbeat or pulse
general body swelling
headache
hives, itching, or rash
indigestion
light-colored stools
loss of appetite
nausea and vomiting
noisy breathing
nosebleeds
pain and fullness in right upper abdomen or stomach
pale skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
reddening of the skin, especially around the ears
sore throat
sweating
swelling of eyes, face, hands, ankles, feet, or lower legs
tightness in the chest
unpleasant breath odor
unusual lumps or masses
vomiting of blood
weight gain or loss
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Indigestion
passing of gas
stomach fullness
Incidence not known
Blue-green to black skin discoloration
hair loss or thinning of the hair
pain, redness, soreness, or sloughing of the skin at the injection site
sores, welting, or blisters

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 9/15/2016

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