Melphalan oral / injection

Melphalan is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Melphalan is used to treat multiple myeloma (a type of blood cancer) and cancer of the ovary.

Melphalan treats only the symptoms of ovarian cancer or multiple myeloma, but does not treat the cancer itself.

Melphalan may also be used for purposes not listed in this medication guide.

You should not use melphalan if you are allergic to it, or if prior treatment with this medication was unsuccessful in controlling your disease.

To make sure melphalan is safe for you, tell your doctor if you have:

• a weak immune system (caused by disease or by using certain medicine);

• liver disease;

• kidney disease; or

• a history of chemotherapy or radiation.

Using melphalan may increase your risk of developing other types of cancer, such as leukemia. Ask your doctor about your specific risk.

Do not use melphalan if you are pregnant. It could harm the unborn baby. Use effective birth control to avoid pregnancy during your treatment with melphalan. Follow your doctor's instructions about how long to prevent pregnancy after your treatment ends.

This medication may affect fertility (your ability to have children), whether you are a man or a woman.

It is not known whether melphalan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Oral melphalan is a tablet you take by mouth. Injectable melphalan is injected into a vein through an IV. A healthcare provider will give you this injection.

Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using melphalan.

Melphalan can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often.

Store melphalan tablets in the refrigerator and protect them from light.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• bone marrow suppression--sudden weakness or ill feeling, fever, chills, pale skin, easy bruising or bleeding, red or pink urine, painful mouth sores, cough, trouble breathing, feeling light-headed, rapid heart rate;

• inflammation of your blood vessels--numbness or tingling, red skin rash, unusual lumps or masses, fever, weight loss, muscle or joint pain, tired feeling, unusual bleeding; or

• liver problems--nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• missed menstrual periods;

• weakness; or

• temporary hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In orally dosed patients with moderate to severe renal impairment, currently available pharmacokinetic data do not justify an absolute recommendation on dosage reduction. However, a reduced initial dose may be appropriate. In intravenously dosed patients, a reduction of up to 50% should be considered in patients with renal insufficiency (BUN greater than or equal to 30 mg/dL).

The following guidelines have been used for adult patients by some clinicians:
CrCl 10 to 50 mL/minute: 75% of dose
CrCl Less than 10 mL/minute: 50% of dose