Side Effects of Melphalan, Warnings, and Other Important Safety Information

Page content

Also known as Alkeran, this medication is used to treat ovarian cancer, multiple melanoma, and in some cases, other types of cancer. It is in a drug class referred to as alkylating agents. It helps to treat cancer by stopping cancer cell growth. The side effects of melphalan and other precautions of this medication should be fully understood by all patients before they begin taking this medication.

How is this Medication Used?

This medication is usually taken once a day by mouth. This medication is often prescribed to be taken when the patient has an empty stomach. The patient’s response to treatment, medical condition, and blood counts will determine their dosage. Patients may take this medication for several weeks, then not take it for several weeks, then begin taking it again for several weeks. Other patients may only take it for just a few days, not take it for several week, then begin a daily regimen. The patient’s doctor will work out their individualized dosage and administration schedule with them. Patients must consume adequate fluids to help the kidneys flush it out of the body, when taking this medications. If a patient misses a dose, or vomits right after a dose, they must contact their physician immediately.

Side Effects

Side effects of melphalan definitely occur and will depend on the patient. Common side effects include nausea and vomiting, loss of appetite, diarrhea, and sores on the lips and in the mouth. Patients may also lose their hair temporarily.

Serious side effects that require the patient to talk to their doctor immediately include:

  • Bleeding or bruising easily
  • Side or lower back pain
  • Decreased sexual function
  • Urination that is painful or difficult
  • Coffee ground-looking vomit
  • Stools that are bloody, black, or tarry
  • Missing or decreased menstrual periods
  • Pinkish urine
  • Abnormal weight loss
  • Signs of infection include chills, fever, persistent sore throat (a high fever warrants immediate medical attention)

Rare and serious side effects require the patient to get emergency medical treatment and they include:

  • Difficult or painful breathing
  • Coughing up blood
  • Abnormal masses or lumps under skin
  • Abdominal pain
  • Dark urine
  • Chest pain
  • Persistent cough
  • Arms or legs becoming red, painful or swollen
  • Jaundice
  • Unusual tiredness


If the patient has certain diseases or disorders, this medication could be contraindicated. Such diseases and disorders include:

  • Allergy to this drug or chlorambucil
  • Other allergies
  • Blood disorders or problems
  • Kidney problems
  • Previous chemotherapy for cancer
  • Radiation treatment
  • Kidney problems

Drug Interactions

If a patient is taking one of the following medications there is a chance a dangerous interaction could occur:

  • Nalidixic acid
  • Cyclosporine
  • Cimetidine
  • Tell the doctor about all medications and over-the-counter products taken before starting this medication

Warnings and Precautions

Though this drug is used to treat certain cancers, it can increase the patient’s risk of developing other types of cancer, such as carcinoma and leukemia. This medication has caused unborn babies to develop birth defects, therefore, it should be avoided during pregnancy and women who are not pregnant must not become pregnant when taking this medications. Pregnant women and women trying to conceive should not even handle this medication, or be near it. Breastfeeding mothers should not take this drug.

Another melphalan warning is that drug may also cause serious blood disorders that result in anemia, low platelet count, and low white blood cell count, resulting from decreased bone marrow function. It can also increase the patient’s risk of bleeding and reduce their ability to fight infections. Patients must also avoid cuts, bruises and other injuries. They should avoid vaccinations and immunizations, and those who have had them recently, while taking this medication.


RxList. (2010). Alkeran. Retrieved on September 1, 2010 from RxList: (2010). Alkeran. Retrieved on September 1, 2010 from