Melphalan (Systemic)

Brand Names : Alkeran, L-PAM, phenylalanine mustard

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For melphalan, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to melphalan or chlorambucil.

Pregnancy - Tell your doctor if you are pregnant or if you intend to have children. There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. In addition, many cancer medicines may cause sterility which could be permanent. Sterility has been reported with melphalan and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are taking melphalan. Tell your doctor right away if you think you have become pregnant while taking melphalan.

Breast-feeding - Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because melphalan may cause serious side effects, breast-feeding is not recommended while you are taking it.

Children - Although there is no specific information comparing use of melphalan in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of melphalan in the elderly with use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking melphalan, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have been treated with x-rays or cancer medicines within 3 to 4 weeks - Melphalan may increase the effects of these medicines or radiation therapy on the blood

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) - Melphalan may raise the concentration of uric acid in the blood, which these medicines are used to lower

Other medical problems - The presence of other medical problems may affect the use of melphalan. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of) - Melphalan may increase levels of a chemical called uric acid in the body, which can cause gout or kidney stones

• Infection - Melphalan decreases your body's ability to fight infection

• Kidney disease - Risk of toxic effects on the blood may be increased