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 w/50mm Catheter; Hepzato w/62mm Catheter

Brand Names: Canada

Alkeran; TARO-Melphalan

What is this drug used for?

• It is used to treat multiple myeloma.
• It is used to treat cancer of the ovary.
• It is used to treat uveal melanoma that has spread to the liver.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

All products:

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you are breast-feeding. Do not breast-feed while you take this drug. You may also need to avoid breast-feeding for some time after your last dose. Talk with your doctor to see if you need to avoid breast-feeding after your last dose.

Hepzato:

• If you are dehydrated or have low blood pressure.
• If you have any of these health problems: Bleeding, blood clotting, or high blood volume.
• If you have brain tumors, heart problems, or liver problems.
• If you have had liver surgery or another procedure on your liver in the past 4 weeks.
• If you are taking a drug for blood thinning, blood clotting, or blood pressure.

This drug may interact with other drugs or health problems.

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

What are some things I need to know or do while I take this drug?

All products:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• If you have a latex allergy, talk with your doctor. Some products have latex.
• You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
• You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
• Talk with your doctor before getting any vaccines. Use of some vaccines with this drug may either raise the chance of an infection or make the vaccine not work as well.
• To help with mouth sores, use a soft toothbrush or cotton swabs and rinse the mouth. Do not use mouth rinses that have alcohol in them.
• If you are 65 or older, use this drug with care. You could have more side effects.
• This drug may cause the ovaries to not work. This may also cause menstrual periods to stop. Talk with the doctor.
• This drug may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child. This may go back to normal but sometimes it may not. If you have questions, talk with your doctor.
• This drug may cause harm to an unborn baby. A pregnancy test will be done before you start this drug to show that you are NOT pregnant.
• If you may become pregnant, use birth control while taking this drug and for 6 months after your last dose. If you get pregnant, call your doctor right away.
• If your sex partner may get pregnant, protect your partner from pregnancy during treatment and for some time after your last dose. Talk with your doctor to see how long to use birth control after you stop this drug.

Hepzato:

• Blood clots have happened with this drug. Sometimes, these blood clots have been deadly. Call your doctor right away if you have chest, arm, back, neck, or jaw pain or pressure; coughing up blood; numbness or weakness on 1 side of your body, trouble speaking or thinking, change in balance, or change in eyesight; shortness of breath; or swelling, warmth, or pain in the leg or arm.

What are some side effects that I need to call my 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 doctor or get medical help right away if you have 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.
• Very bad and sometimes deadly lung or breathing problems have happened with this drug. Call your doctor right away if you have lung or breathing problems like trouble breathing, shortness of breath, or a cough that is new or worse.

Injection:

• This drug may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your 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 doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

• Mouth irritation or mouth sores.
• Feeling tired or weak.
• Constipation.
• Stomach pain.
• Diarrhea, throwing up, upset stomach, and decreased appetite are common with this drug. If these happen, talk with your doctor about ways to lower these side effects. Call your doctor right away if any of these effects bother you, do not get better, or are severe.

Injection and tablet:

• Change in taste.
• Weight loss.

Hepzato:

• Groin pain.
• Headache.

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

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Tablets:

• Take on an empty stomach. Take 1 hour before or 2 hours after meals.
• Take 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.

Hepzato:

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

What do I do if I miss a dose?

Tablets:

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

Injection:

• Call your doctor to find out what to do.

Hepzato:

• 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 doctor, nurse, or pharmacist about how to store it.

Hepzato:

• This drug will be given in a healthcare setting. You will not store it at home.

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 symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your 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

2024-08-29

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