WARNING

Alkeran (melphalan) is a chemotherapy drug used to treat certain types of cancer. Here are some brief points about its risks:

• Bone Marrow Suppression: It can lower blood cell counts, increasing the risk of infections, bleeding, and anemia.
• Nausea and Vomiting: Common side effects include nausea and vomiting.
• Liver Toxicity: It can cause liver damage, leading to elevated liver enzymes.
• Kidney Damage: There’s a risk of kidney damage or impaired kidney function.
• Increased Risk of Secondary Cancers: Long-term use can increase the risk of developing secondary cancers.
• Allergic Reactions: There’s a potential for allergic reactions, including rash or swelling.

Always discuss potential side effects and risks with your healthcare provider before starting treatment.

Why is this medication prescribed?

Alkeran Injection (melphalan) is prescribed primarily for the treatment of certain types of cancer, including:

• Multiple Myeloma: A cancer of the plasma cells in the bone marrow. Melphalan is used to help control the growth of cancer cells in this condition.
• Ovarian Cancer: Specifically, it is used in cases where the cancer has not responded to other treatments or is resistant to them.
• Some Types of Leukemia: In combination with other drugs, it can be used to treat certain types of leukemia.

Melphalan works by interfering with the growth of cancer cells, ultimately helping to shrink tumors and manage symptoms associated with these cancers.

How should this medicine be used?

Usage Guidelines:

• Administration: Melphalan is given as an injection into a vein, usually by a healthcare professional. The dosage and schedule depend on the specific cancer being treated, the patient’s overall health, and other factors.
• Dosage: The dosage is carefully calculated based on the patient’s condition, weight, and response to the medication. The healthcare provider will determine the appropriate dose and frequency.
• Monitoring: Regular blood tests are needed to monitor blood cell counts and liver/kidney function due to the risk of side effects.
• Hydration: Staying well-hydrated may help to reduce the risk of kidney damage associated with the drug.

Always follow your healthcare provider’s instructions regarding the administration and monitoring of Alkeran.

Other uses for this medicine

In addition to treating multiple myeloma, ovarian cancer, and certain types of leukemia, melphalan may also be used in:

• Lymphoma: Particularly in some cases of non-Hodgkin lymphoma.
• Preparation for Bone Marrow Transplant: In combination with other drugs to condition the body before a stem cell or bone marrow transplant.

What special precautions should I follow?

Special Precautions to Follow for Alkeran Injection:

• Regular Monitoring: Frequent blood tests are essential to monitor blood cell counts and liver/kidney function. This helps manage potential side effects and adjust treatment as needed.
• Infection Risk: Be aware of signs of infection (fever, sore throat) due to the risk of bone marrow suppression. Practice good hygiene and avoid contact with sick individuals.
• Bleeding and Bruising: Melphalan can increase bleeding risk. Report any unusual bruising, bleeding, or prolonged bleeding to your healthcare provider.
• Hydration: Ensure adequate hydration to help prevent kidney damage. Your healthcare provider may give specific instructions on fluid intake.
• Pregnancy and Breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding, as melphalan can harm an unborn baby and may pass into breast milk.
• Drug Interactions: Inform your healthcare provider of all medications and supplements you are taking, as melphalan can interact with other drugs.
• Vaccinations: Avoid live vaccines while on melphalan and consult your healthcare provider before getting any vaccinations.

Always follow the specific instructions provided by your healthcare provider and report any side effects or concerns promptly.

What special dietary instructions should I follow?

• Balanced Diet: Maintain a well-balanced diet to support overall health and manage potential side effects like nausea. Your healthcare provider or a dietitian can provide specific recommendations based on your condition and treatment.
• Hydration: Adequate fluid intake is crucial to help prevent dehydration and kidney issues.
• Avoid Certain Foods: Some patients may need to avoid specific foods or drinks based on individual side effects or interactions. Consult with your healthcare provider for personalized advice.

What should I do if I forget a dose?

• Contact Your Healthcare Provider: If you miss a dose, contact your healthcare provider for instructions. Do not try to make up for a missed dose on your own.
• Follow Instructions: Your healthcare provider will provide guidance on whether to reschedule the missed dose or continue with your next scheduled dose.

What side effects can this medication cause?

Alkeran (melphalan) can cause a range of side effects. Some common and serious side effects include:

Common Side Effects:

• Nausea and Vomiting: These are frequent, but they can often be managed with medications.
• Loss of Appetite: You might experience a decrease in appetite, which can affect your overall nutrition.
• Fatigue: Feeling tired or weak is common during treatment.
• Hair Loss: Temporary hair loss may occur.
• Diarrhea or Constipation: Digestive issues can arise during treatment.

Serious Side Effects:

• Bone Marrow Suppression: This can lead to low blood cell counts, increasing the risk of infections, bleeding, and anemia.
• Infections: Due to a suppressed immune system, you may be more susceptible to infections.
• Liver Damage: Signs include jaundice (yellowing of the skin or eyes), dark urine, or severe abdominal pain.
• Kidney Damage: Watch for symptoms like decreased urine output, swelling in the legs or ankles, or changes in kidney function tests.
• Bleeding and Bruising: Increased risk due to lower blood cell counts.
• Secondary Cancers: Long-term use may increase the risk of developing secondary cancers.
• Allergic Reactions: Rash, itching, swelling, severe dizziness, or trouble breathing.

It’s important to report any side effects to your healthcare provider, as they can offer treatments or adjustments to manage them effectively.

What should I know about storage and disposal of this medication?

Storage and Disposal of Alkeran Injection:

• Storage:
  • Store Alkeran Injection according to the manufacturer’s instructions, usually at room temperature, away from light and moisture.
  • Keep it in its original packaging and out of reach of children and pets.
  • Do not use the medication after its expiration date. Check the label for specific storage instructions.
• Disposal:
  • Dispose of unused or expired Alkeran Injection properly. Do not flush it down the toilet or pour it into a drain.
  • Use a medication take-back program or a community drug take-back event if available.
  • Ask your pharmacist or healthcare provider for guidance on proper disposal methods.

In case of emergency/overdose

• Emergency Contact: If an overdose is suspected or if you experience severe side effects, contact emergency medical services or go to the nearest emergency room immediately.
• Symptoms of Overdose: Symptoms can vary but may include severe nausea, vomiting, diarrhea, or signs of significant bone marrow suppression such as extreme fatigue, unusual bleeding, or infections.

What other information should I know?

• Communication with Healthcare Provider: Inform your healthcare provider of your complete medical history, including any other health conditions or treatments. Let your provider know about any allergies you have, especially to medications. Discuss your pregnancy status or plans, and avoid breastfeeding during treatment.
• Follow-up Appointments: Attend all scheduled follow-up appointments and lab tests to monitor your response to treatment and manage any side effects.
• Diet and Lifestyle: Follow any dietary or lifestyle recommendations given by your healthcare provider to support your treatment and overall health.
• Informing Others: Make sure that family members or caregivers are aware of your treatment and know how to assist in case of emergencies or side effects.

Always follow the specific instructions provided by your healthcare team and seek their advice for any concerns or questions about your treatment with Alkeran.