Melphalan hydrochloride
Trade Names:
L-Phenylalanine Mustard, L-PAM, Alkeran, L-Sarcolysin
Type of Drug:
Melphalan hydrochloride belongs to the general group of chemotherapy drugs known as alkylating agents. It is used to treat multiple myeloma and ovarian cancer.
How Drug Works:
Melphalan hydrochloride stops the growth of cancer cells, causing them to die.
How Drug Is Given:
Melphalan hydrochloride is a pill taken by mouth. It can also be given in high doses as an injection in a vein (investigational). Take the pill on an empty stomach, usually once a day for 5 days, every 6 weeks. You will be given antinausea medicine before taking the high-dose melphalan. The dose depends on your size, why you are taking it, and what regimen is used. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.
How Should I Take This Drug?
Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. This drug can be given at different strengths depending on the type of cancer being treated. Dosage may vary depending on your weight and your type of cancer.
Read the following information. If you do not understand it or if any of it causes you special concern, check with your doctor.

Before taking this drug, tell your doctor:

  • If you are trying to become pregnant, are pregnant, or breastfeeding. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. However, do not use oral contraceptives ("the pill") without checking with your doctor.

  • If you think you may want to have children in the future. Many chemotherapy drugs can cause sterility.

  • If you have any of the following medical problems: chickenpox or exposure to chickenpox, gout, heart disease, congestive heart failure, shingles, kidney stones, liver disease, or other forms of cancer.

  • If you are taking any other prescription or over-the-counter drugs, including vitamins and herbals.
Should I avoid any other medicines, foods, alcohol, and/or activities?
Your prescription and nonprescription medicines may interact with other drugs, causing harm. Certain foods or alcohol can also interact with drug products. Never begin taking a new medicine"prescription or nonprescription"without asking your doctor or nurse if it will interact with alcohol, food, or other medicines. Some drug products can cause drowsiness and affect activities such as driving.
Precautions:
Melphalan hydrochloride can lower your blood counts (white blood cells, red blood cells, platelets). Your doctor will check your blood counts before and after each treatment to see its effect. Your doctor or nurse will give you specific instructions if your blood counts are low.
Melphalan hydrochloride can decrease your white blood cell count, especially 16 to 21 days after the drug is given. This can increase your risk of getting an infection. Report fever of 100.5¡F or higher, or signs of infection such as pain in passing your urine, coughing, and bringing up sputum.
Melphalan hydrochloride can decrease your platelet count. This can increase your risk of bleeding. DO NOT take any aspirin or aspirin-containing medicines. Report unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
While you are being treated with melphalan hydrochloride, and after you stop treatment, do not have any immunizations (vaccinations) without your doctor's okay. Try to avoid contact with people who have recently taken the oral polio vaccine. Check with your doctor about this.
Tell all the doctors, dentists, and pharmacists you visit that you are taking this drug.
  • Most of the following side effects probably will not occur.
  • Your doctor or nurse will want to discuss specific care instructions with you.
  • They can help you understand these side effects and help you deal with them.
Side Effects:
More Common Side Effects
  • Nausea (at higher doses)
  • Vomiting (at higher doses)
  • Fetal changes if pregnancy occurs while taking this drug
  • Decreased white blood cell count with increased risk of infection
  • Decreased platelet count with increased risk of bleeding
Rare Side Effects
  • Severe allergic reaction (intravenous form)
  • Loss of appetite
  • Scarring of lung tissue with prolonged use
  • Hair loss
  • Rash
  • Itching
Side Effects / Symptoms of the Drug

Because of the way this drug acts on the body, there is a chance that it can cause other side effects that may not occur until months or years after the drug is used. This drug can very rarely cause a second cancer such as leukemia. Discuss this with your doctor.
Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop any problems.
FDA Approval: This drug is approved for cancer treatment.