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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.

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

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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.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Call your doctor for instructions if you miss an appointment for your melphalan injection.

What should I avoid while taking melphalan?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using melphalan. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

melphalan can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Melphalan side effects

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
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