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Applies to melphalan: oral tablet
Other dosage forms:
Oral route (Tablet)
Severe bone marrow suppression with resulting infection or bleeding may occur. Melphalan is leukemogenic in humans. Melphalan produces chromosomal aberrations in vitro and in vivo and, therefore, should be considered potentially mutagenic in humans.
Along with their needed effects, medicines like melphalan can sometimes cause unwanted effects such as blood problems and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Along with its needed effects, melphalan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking melphalan:
Some side effects of melphalan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
For Healthcare Professionals
Applies to melphalan: intravenous powder for injection, oral tabletHematologic
Rare (less than 0.1%): Hemolytic anemiaOncologic
Frequency not reported: Secondary malignancies (e.g., acute nonlymphocytic leukemia, myeloproliferative syndrome, carcinomaRespiratory
Rare (less than 0.1%): Interstitial pneumonitis, pulmonary fibrosis
Frequency not reported: Bronchospasm, dyspneaDermatologic
Very common (10% or more): Alopecia (at high dose)
Common (1% to 10%): Alopecia (at conventional dose)
Rare (less than 0.1%): Maculopapular rash, pruritus
Frequency not reported: Skin hypersensitivity, skin necrosis (rarely requiring skin grafting)Cardiovascular
Frequency not reported: Tachycardia, hypotension, vasculitisGastrointestinal
Very common (10% or more): Nausea, vomiting, diarrhea, stomatitis (at high dose)
Rare (less than 0.1%): Stomatitis (at conventional dose)Hepatic
Rare (less than 0.1%): Abnormal liver function tests to clinical manifestations such as hepatitis and jaundice; veno-occlusive disease following high dose treatmentHypersensitivity
Uncommon (0.1% to 1%): Allergic reactions (e.g., urticaria, edema, skin rashes, anaphylactic shock)Other
Very common (10% or more): Warmth, tingling
Frequency not reported: Chromosome damageRenal
Common (1% to 10%): Temporary significant elevation of the blood urea has been seen in the early stages of therapy with this drug in myeloma patients with renal damageLocal
Frequency not reported: Skin ulceration at injection siteMusculoskeletal
Very common (10% or more): Muscle atrophy, muscle fibrosis, myalgia, blood creatine phosphokinase increased
Common (1% to 10%): Compartment syndrome
Frequency not reported: Muscle necrosis, rhabdomyolysis
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