melphalan at a glance
Medicine class
Alkylating cytotoxic chemotherapy
Licensed tablet uses
Multiple myeloma, advanced ovarian or breast cancer, and polycythaemia vera
Key monitoring
Frequent blood counts because bone-marrow suppression may be severe or delayed
Tablet handling
Swallow whole; do not break, crush, chew or divide
Storage
Keep refrigerated at 2°C to 8°C and out of children’s reach
What is melphalan used for?
The selected tablet product is licensed for:
Multiple myeloma
Advanced ovarian adenocarcinoma
Advanced breast carcinoma, alone or with other treatments
Polycythaemia vera
How does melphalan work?
Melphalan is a nitrogen-mustard alkylating agent. It forms covalent links with guanine in DNA, cross-linking DNA strands and preventing cells from replicating. Rapidly dividing cells are particularly vulnerable.
melphalan preparations and strengths
Tablet
Route: Oral
Strengths: 2 mg
How to take melphalan
Take tablets exactly as shown on the dispensing label and follow the oncology team’s instructions about meals. Food can reduce and delay oral absorption, so consistent administration matters.
Swallow tablets whole with water.
Do not break, crush, chew or divide them.
Do not alter or stop treatment without speaking to the specialist team.
Return unwanted tablets to a pharmacy; do not put them in household waste or wastewater.
melphalan side effects
Common or expected effects
- Reduced blood-cell production, which can cause infection risk, anaemia, bruising or bleeding
- Nausea, vomiting or diarrhoea
- Hair loss or thinning
- Sore mouth or mouth ulcers
Get urgent medical advice
- Severe infection or profound bone-marrow suppression
- Severe allergic reaction
- Blood clot in a limb or lungs, particularly with some combination treatments
- New or worsening breathlessness, cough or wheeze suggesting lung toxicity
- Jaundice or other significant liver problems
- Acute kidney injury
- Later development of myelodysplastic syndrome, leukaemia or another malignancy
melphalan in pregnancy
Melphalan should be avoided during pregnancy whenever possible, particularly in the first trimester, because its DNA-damaging action may harm the fetus. Pregnancy, suspected pregnancy and future fertility plans require prompt discussion with the oncology team. The SmPC advises effective contraception during treatment and for six months afterwards for female patients, and for three months afterwards for male patients.
melphalan while breastfeeding
Breastfeeding is contraindicated while receiving melphalan. Discuss when breastfeeding could safely begin with the oncology and maternity teams after treatment ends.
melphalan interactions
The specialist team should review prescribed, non-prescription and complementary products before treatment.
Live vaccines
Avoid because immunosuppression can allow the vaccine organism to cause infection.
Nalidixic acid
Use with intensive intravenous melphalan has caused fatal haemorrhagic enterocolitis in children.
Ciclosporin
Kidney impairment has occurred when ciclosporin followed intensive melphalan conditioning for transplantation.
Busulfan in children
The sequence of busulfan and melphalan administration may influence toxicity.
Common questions about melphalan
Answers are fully visible for fast scanning and source review.
Is melphalan chemotherapy?
Yes. Melphalan is an alkylating cytotoxic chemotherapy that cross-links DNA and prevents susceptible cells from multiplying.
What conditions are melphalan tablets licensed to treat?
The selected tablets are licensed for multiple myeloma, advanced ovarian and breast cancer, and polycythaemia vera.
Can melphalan tablets be taken with food?
Food can reduce and delay absorption. Follow the oncology team’s instructions about meals and take the tablets consistently as directed.
Can melphalan tablets be crushed or split?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.