Brand Name(s):

• Alkeran^® Injection

Other Name(s):    TOP

• Phenylalanine mustard

IMPORTANT WARNING    TOP

Melphalan injection should be given only under the supervision of a doctor with experience in the use of chemotherapy medications.

Melphalan can cause a severe decrease in the number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; bloody vomit; or vomiting blood or brown material that resembles coffee grounds.

Keep all appointments with your doctor and the laboratory. Your doctor will order laboratory tests regularly before and during your treatment to see if your blood cells are affected by this drug.

Melphalan may increase the risk that you will develop other cancers. Talk with your doctor about the risks of taking melphalan.

WHY is this medicine prescribed?    TOP

Melphalan injection is used to treat multiple myeloma (a type of cancer of the bone marrow). Melphalan injection should only be used to treat people who are unable to take melphalan by mouth. Melphalan is in a class of medications called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

HOW should this medicine be used?    TOP

Melphalan injection comes as a powder to be mixed with liquid to be slowly injected intravenously (into a vein) over 15 to 30 minutes by a doctor or nurse in a medical facility. It is usually given once every 2 weeks for 4 doses and afterwards, once every 4 weeks. The length of treatment depends on how well your body responds to treatment.

Your doctor may need to delay your treatment or adjust your dose if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with melphalan

Are there OTHER USES for this medicine?    TOP

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?    TOP

Before receiving melphalan injection,

• tell your doctor and pharmacist if you are allergic to melphalan, any other medications, or any of the ingredients in melphalan injection. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: carmustine (BICNU, BCNU), cisplatin (Platinol AQ), cyclosporine (Sandimmune, Gengraf, Neoral), or interferon alfa (Intron A, Infergen, Alferon N).
• tell your doctor if you have taken melphalan before, but your cancer did not respond to the medication. Your doctor will probably not want you to receive melphalan injection.
• tell your doctor if you have received radiation therapy or other chemotherapy recently or if you have or have ever had kidney disease.
• you should know that melphalan may interfere with the normal menstrual cycle (period) in women and may temporarily or permanently stop sperm production in men. Melphalan may cause infertility (difficulty becoming pregnant); however, you should not assume that you cannot get pregnant or that you cannot 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 or breast-feed 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 without talking to your doctor.

What SIDE EFFECTS can this medicine cause?    TOP

What should I do in case of OVERDOSE?    TOP

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at Web Site. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• severe nausea
• severe vomiting
• severe diarrhea
• sores in the mouth and throat
• black, tarry, or bloody stools
• bloody vomit or vomited material that looks like coffee grounds
• unusual bruising or bleeding
• seizures
• decreased consciousness
• loss of the ability to move muscles and to feel a part of the body

What OTHER INFORMATION should I know?    TOP

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

AHFS^® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: August 15, 2012.