Melphalan will be prescribed for you by a specialist doctor.
Keep your regular appointments with your doctor or hospital. You will need to have frequent blood tests.
If you think you are getting an infection or if you have a high temperature, please contact your doctor straightaway.
About melphalan tablets
|Type of medicine||An alkylating chemotherapy medicine|
|Used for||Multiple myeloma; polycythaemia vera|
Melphalan is used to treat some cancers and conditions where cells in the body rapidly divide and multiply. It is most commonly prescribed for conditions such as multiple myeloma and polycythaemia vera. Multiple myeloma is a cancer of the bone marrow. Polycythaemia vera is a bone marrow disease that leads to an abnormal increase in the number of red blood cells in the body. It makes your blood 'thicker' and can make you feel dizzy and short of breath.
In these conditions, certain cells in the body grow and multiply too fast. Melphalan works by preventing cells from multiplying. This reduces the number of cancer cells or unwanted blood cells.
Before taking melphalan
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking melphalan it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have any problems with the way your kidneys work.
- If you have an infection or feel unwell.
- If you have a rare inherited blood condition called porphyria.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take melphalan
- Before you start this treatment, read any printed information you have been given by your doctor and the printed manufacturer's leaflet from inside your pack of tablets. These will give you more information about melphalan and will provide you with a full list of the side-effects which you may experience from taking it.
- Melphalan will be prescribed for you by a specialist doctor who is experienced in treating your condition. Your doctor will calculate what dose is right for you and will tell you how to take it. The dose you are prescribed will depend upon the reason why you are taking it, so it is important that you take the tablets exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said to you but if you are unsure about how to take the tablets, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
- Swallow melphalan tablets whole with a drink of water. Do not break, crush or chew the tablets before you swallow.
- If you are sick shortly after taking a dose, or if you forget to take a dose at the correct time, contact your doctor or clinic for advice on what to do.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests and check-ups during your treatment with melphalan.
- It is important that you do not get pregnant or father a child while you are taking melphalan. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. If you would like to have children in the future, you should ask your doctor for advice about family planning before you begin taking melphalan. This is particularly important if you are a man, as there is a risk of reduced male fertility or sterility with melphalan treatment.
- While you are taking melphalan and for six months after you have stopped the treatment, do not have any immunisations (vaccinations) without talking to your specialist doctor first. Melphalan lowers your body's resistance and there is a risk that you will get an infection from some vaccines.
Can melphalan cause problems?
Medicines used to treat cancer can have a number of side-effects, some of which can be delayed for several days or weeks after taking the medicine. Most chemotherapy medicines can lower the number of white cells in your blood, which increases the risk of you getting an infection. While you are taking melphalan you should take precautions to reduce the risk of getting an infection - you can do this by avoiding being with people who you know have an infection. If you think you are getting a sore throat or if you have a high temperature, please let your doctor know as soon as possible so that you can get some treatment straightaway.
Your doctor will discuss with you the possibility of unwanted side-effects from your treatment with melphalan, although not everyone experiences these. The table below contains some of the side-effects associated with melphalan. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Please let your doctor know if you experience any of the following:
|Very common melphalan side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|A high temperature, or symptoms of an infection||Let your doctor know about this straightaway|
|Feeling or being sick||Stick to simple foods. Let your doctor know about this, as you can be given an anti-sickness medicine|
|Diarrhoea||Drink plenty of water to replace lost fluids. If this continues, speak with your doctor|
|Common melphalan side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Mouth ulcers||Brushing your teeth 2-3 times a day with a soft toothbrush and regularly using a mouth rinse may help to prevent this. If mouth ulcers become a problem, speak with your doctor|
|Raised levels of urea in your blood||Your doctor will check for this|
|Hair loss||This is not permanent but speak with your doctor if you are concerned about it|
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store melphalan
- Keep all medicines out of the reach and sight of children.
- Melphalan tablets should be stored in a refrigerator at 2°C to 8°C and kept dry.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
If you buy any medicines, always check with a pharmacist that they are suitable for you to take with your prescribed medicines.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Alkeran® 2 mg Tablets; Aspen, The electronic Medicines Compendium. Dated January 2014.
- British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox