Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Anemia: Melphalan may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.
Fertility: Sterility may occur with the use of melphalan.
Gout: This medication may cause high levels of uric acid in the blood, making gout more likely to occur.
Infection and vaccines: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice the signs of an infection such as fever or chills. Also tell your doctor if you have been vaccinated, or are planning to be vaccinated with a live vaccine.
Kidney problems: Kidney disease or reduced kidney function may cause this medication to build up in the body, increasing the risk of side effects. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lung problems: In rare cases, melphalan can cause lung problems (pulmonary fibrosis, permanent scarring of the lungs or interstitial pneumonitis, inflammation of the lungs) that, in some cases, can be fatal. If you experience any difficulty breathing, wheezing, fever, shortness of breath, cough, or coughing up of blood, accompanied by weakness and weight loss while taking melphalan, tell your doctor immediately.
Secondary cancer: When used for long periods of time, this medication can increase the risk of developing leukemia. If you have any concerns, talk to your doctor about the risks and benefits of using this medication.
Pregnancy: There is a possibility of birth defect if either the man or the woman is taking melphalan at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using this medication.
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking melphalan, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children.