Melphalan can cause serious side effects, including: decreased bone marrow function and blood problems (easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms, bloody or black stools, pale or yellowed skin, confusion or weakness); breathing problems; or liver damage (nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice [yellowing of the skin or eyes]). Call your doctor at once if you have any of these side effects.

In some cases, second cancers have been reported to occur during and after treatment with melphalan. Talk to your doctor about your individual risk and benefit of this medication.

What is melphalan?

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

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

Melphalan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using melphalan?

Before using melphalan, tell your doctor if you have:

• kidney disease; or

• decreased bone marrow (from other diseases or medications).

If you have any of these conditions, you may not be able to use melphalan, or you may need a dosage adjustment or special tests during treatment.

Do not use melphalan if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

This medication can 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. Do not take melphalan without telling your doctor if you are breast feeding a baby.

How should I take melphalan?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger or smaller amounts, or take it for longer than recommended by your doctor.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take the melphalan oral tablet with a large glass of water.

Melphalan injection is given through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection in a clinic or hospital setting.

Tell your doctor right away if any of the melphalan injection gets on your skin or if you feel pain, burning, or other skin irritation when the medicine is injected.

Melphalan is usually given for a few weeks at a time, followed by a 4-week period off the drug, during which your blood is tested to see how your body responded to the medication. Your doctor will determine how often you use melphalan and for how long. Follow your doctor's instructions carefully.

Melphalan can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

Store melphalan tablets in the refrigerator and protect them from light. If you store melphalan injection at home, keep it at room temperature and protect it from heat, moisture, and light.

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