About melphalan

Melphalan is a cytotoxic medicine which is used in conditions where cells in the body are rapidly dividing and multiplying, such as in multiple myeloma and polycythaemia vera. Multiple myeloma is a cancer of the bone marrow, and polycythaemia vera is a bone marrow disease that leads to an abnormal increase in the number of red blood cells.

Melphalan works by stopping cells from multiplying. It does this by binding to and damaging the DNA in cells. This helps stop the increase in the number of cancer cells or unwanted blood cells.

Before taking melphalan

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking melphalan it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have an infection or feel unwell.
• If you have kidney problems.
• If you have porphyria (this is a rare inherited blood disorder).
• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have ever had an allergic reaction to any medicine.

How to take melphalan

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about melphalan, and a full list of possible side-effects from taking it.
• Melphalan will be given to you by a specialist doctor who is experienced in treating your condition. Take it exactly as your doctor tells you to. Your dose will depend on the reason why you are taking it. Your doctor or pharmacist will tell you how many tablets to take and which days to take them. Your dose will also be on the label of your pack. If you are unsure about how to take melphalan tablets, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
• Swallow melphalan tablets whole with a drink of water. Do not break, crush or chew them.
• If you are sick shortly after taking a dose, or if you forget a dose, contact your doctor or clinic for advice of what to do. You will be told whether to take the dose again, or wait until the next dose is due.

Getting the most from your treatment

• You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests during your treatment with melphalan.
• It is important that you do not get pregnant or father a child while you are taking melphalan. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
• If you intend to have children in the future, you should ask your doctor for advice about family planning before you begin taking melphalan. This is particularly important if you are a man, as there is a risk of reduced fertility after melphalan treatment.
• While you are taking melphalan and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Melphalan lowers your body's resistance and there is a chance that you may get an infection from some vaccines.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are taking melphalan.

Can melphalan cause problems?

Melphalan can lower the number of white cells in your blood, increasing the chance of you getting an infection. You should take certain precautions to reduce the risk of infection - if possible, avoid people with infections and let your doctor know if you think you are getting a sore throat or if you have a high temperature.

Your doctor will have discussed with you the possibility of unwanted side-effects of treatment with melphalan. Let your doctor know if you experience any of the following:

Important: if you experience any of the following, speak with your doctor immediately or go to your local accident and emergency department without delay:

• Any sign of fever or infection.
• Any sudden wheeziness or any difficulties with your breathing. This may be a sign of an allergic reaction, or a rare but serious lung condition.
• A skin rash. This may be a sign of an allergic reaction.
• Jaundice (yellowing of your skin or the whites of your eyes).

How to store melphalan

• Keep all medicines out of the reach and sight of children.
• Melphalan tablets should be stored in a refrigerator at 2°C to 8°C and kept dry.

Important information about all medicines