Melphalan (Alkeran)

How does this medicine work?

Melphalan (mel-fa-lan) is used to treat certain types of cancer. It interferes with the growth of cancer cells, causing them to be destroyed.

How is it given?

Melphalan is given into the vein (IV) during a hospital stay or may be taken by mouth.

Melphalan should be taken at regular times to keep a steady level in the bloodstream. Your child should be awake and alert when taking any medicine by mouth.

___ For children who cannot swallow tablets:

1. Put on gloves.
2. Crush the tablet in a tablet crusher or between 2 spoons inside a clear plastic bag.
3. Mix the powder with a very small amount (1 teaspoon) of soft food, such as applesauce, chocolate syrup, ice cream, jelly, or yogurt. Make sure your child takes all of the mixture.
4. Wash spoons and container right after use. Discard the plastic bag and gloves.

What should I do if a dose is missed?

If one dose is missed, give it as soon as you remember. Never give a double dose.

If your child vomits within 30 minutes after receiving a dose, give it again. If your child vomits after 30 minutes, do not repeat the dose. Call the oncology clinic if more than one dose is missed or vomited.

Are there any precautions about food or other medicines?

The tablet should be taken on an empty stomach (1 hour before or 2 hours after eating. Do not give it with H-2 blockers such as ranitidine (Zantac®), as they can decrease its absorption.

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What are the side effects?

Common

• low blood counts
• nausea and vomiting
• diarrhea
• hair loss
• mouth sores

Occasional

• cough
• fever
• chills
• sore throat
• skin rash
• missed menstrual periods
• unusual bruising or bleeding

Rare

• damage or scarring of lung tissue
• low blood pressure
• inability to have children
• secondary cancer or leukemia
• allergic reaction

When should I call the clinic?

• fever
• bruises
• painful or difficult urination
• unusual bleeding
• continued nausea, vomiting, or diarrhea
• signs of dehydration
• continued cough
• shortness of breath
• chest pain
• signs of allergic reaction:
  
  • rash or hives
  • wheezing
  • trouble breathing - call 911

What else do I need to know?

Report any signs of an allergic reaction during the infusion.

You will need to maintain adequate hydration during the infusion and for 24 hours afterward. Therefore, increased IV fluids will be given during this time.

All caregivers should wear gloves when handling urine, stool, and vomit while your child is receiving the chemotherapy and for 48 hours afterward. Urine, stool, and vomit can be safely disposed of in septic tanks and the sewer system.

Any clothing or bed linens that are contaminated with urine, stool, or vomit should be washed separately from other laundry in hot water and detergent. Anyone handling the contaminated laundry should wear gloves.

Good mouth care will help prevent mouth sores.

Blood samples may be needed to check the effects of the medicine. Blood counts are lowest at 14 to 21 days after the medicine is given, and return to normal in 4 to 5 weeks after stopping it.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care.

Always make sure you have enough medicine on hand. Each time you refill your prescription, check to see how many refills are left. If no refills are left the pharmacy will need 2 or 3 days to contact the clinic to renew the prescription.

Before giving the first dose, read the label. Be sure it is what was prescribed. After a refill, if the medicine looks different to you, ask your pharmacist or call the oncology clinic before giving it.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program empty them into the trash. Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of chemotherapy medicine is taken, call the oncology clinic right away. If your child is unconscious or has a seizure, call 911.

Questions?

This is not specific to your child but provides general information. If you have any questions, please call the oncology clinic or pharmacy.

Children's Hospitals and Clinics of Minnesota
Last reviewed 8/2015 

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