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Melphalan, prednisolone and thalidomide (MPT)

Find out what MPT is, how you have it and other important information about taking MPT. 

MPT is a cancer drug combination made up of the drugs:

  • M - melphalan, which is a chemotherapy drug
  • P - prednisolone, a steroid
  • T - thalidomide, a targeted cancer drug

It is a treatment for myeloma that has spread or come back. 

How it works

The chemotherapy drug melphalan destroys quickly dividing cells, such as cancer cells. Thalidomide affects all sorts of cell processes, including how cells divide and grow.

How you have it

You take all of the drugs as tablets or capsules.

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.

When you have it

You usually have MPT chemotherapy as cycles of treatment. Each cycle of treatment lasts either 4 weeks or 6 weeks. Depending on your needs you have between 6 and 12 cycles of treatment. This takes between 6 and 18 months in total.


You have melphalan tablets once a day for the first 4 or 7 days of each cycle of treatment. You should swallow the tablets whole with a glass of water at least an hour before eating. You need to keep the tablets in the fridge.   


You take prednisolone tablets once a day for the first 4 or 7 days of the cycle of treatment. You swallow them whole with a glass of water and take them with food or immediately after eating.  


You take thalidomide capsules at night with a glass of water. Swallow them whole. You take them every day throughout the time you are having treatment. You can take thalidomide with or without food. You usually start on a low dose and your doctor then increases the dose unless you get bad side effects.

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 drinks

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

Thalidomide can cause birth defects in children. So you must not become pregnant or father a child while you are taking this drug, and for a time afterwards. Your doctor or nurse will talk to you about contraception before you have the treatment.

Some people worry about taking thalidomide but it does not cause physical defects in adults.

Because thalidomide causes birth defects, you have to sign a consent form before you start treatment. This is to make sure you understand the risks of taking thalidomide and agree to use contraception for a specified period of time. 

If you are a woman of child bearing age you will need to have regular pregnancy tests during the treatment. Your doctor or nurse will tell you about this. 

Pregnant women should not touch or handle thalidomide. You must store it in a place where pregnant women or children cannot reach it.

Men with a female partner who could become pregnant should use condoms during sex for the time they are having treatment and for a week after finishing treatment. You must not donate semen during treatment or for 1 week afterwards.


You may not be able to become pregnant or father a child after treatment with these drugs. 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.


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

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.


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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