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Melphalan (Alkeran)

Find out what melphalan is, how you have it and other important information about taking this chemotherapy drug. 

Melphalan is a treatment for several different types of cancer, including myeloma. It is also called Alkeran.

How it works

Melphalan is one of a group of drugs called alkylating agents. It sticks to one of the cancer cell's DNA strands. DNA is the genetic code that is in the nucleus of all animal and plant cells. It controls everything the cell does. The cell cannot then grow and divide into 2 new cells.

How you have it

Melphalan is a clear liquid that you have as a drip (intravenous infusion).

It also comes as a white tablet, that you take on an empty stomach. You should swallow them whole with a glass of water. Don't crush or chew them. Store them in the fridge. 

Tell your doctor or go to the hospital straight away if you accidently take more melphalan than you should. 

If you forget to take melphalan tell your doctor. Don't take a double dose to make up for the missed dose. 

Most people having melphalan for myeloma, will take it as a tablet.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

You usually have melphalan as a course of several cycles of treatment. Your treatment plan depends on which type of cancer you have. 

For example, if you have myeloma you often have melphalan as part of a combination of drugs, including a steroid (such as prednisolone) and a biological therapy (such as thalidomide). In this case, you might take melphalan for the first 4 or 7 days of each cycle of treatment. A cycle usually lasts 4 or 6 weeks. You may have between 6 and 12 cycles.

Some people might have high doses of melphalan with a stem cell transplant. You have high dose melphalan directly into your bloodstream (intravenously), usually through a central line.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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