Melphalan Tablets

Before you take Melphalan

Do not take Melphalan if:

• You are allergic (hypersensitive) to melphalan or any of the other ingredients of Melphalan tablets
• Do not take if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Melphalan.
• Take special care with Melphalan

Before you take Melphalan, tell your doctor or pharmacist if:

• You have had radiotherapy or chemotherapy, now or recently
  You have a kidney problem.
• If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Melphalan.

Taking other medicines

• Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This includes herbal medicines.
• In particular, you must tell your doctor if you are taking any of the following:
  1) other cytotoxic drugs (chemotherapy)
  2) nalidixic acid (an antibiotic used to treat urinary tract infections)
  3) ciclosporin (used to prevent rejection of organs or tissues following a transplant or to treat certain skin conditions like psoriasis and eczema or to treat rheumatoid arthritis).

Having vaccines while you are taking Melphalan

• If you are going to have a vaccination speak to your doctor or nurse before you have it. This is because some vaccines (like polio, measles, mumps and rubella) may give you an infection if you have them whilst you are taking Melphalan.

Pregnancy and breast-feeding

• Do not take Melphalan if you are planning to have a baby.
• This applies to both men and women. Melphalan may harm your sperm or eggs.
• Reliable contraceptive precautions must be taken to avoid pregnancy whilst you or your partner are taking these tablets.
• Ask your doctor for advice. If you are already pregnant, it is important to talk to your doctor before taking Melphalan.
• Do not breast-feed while taking Melphalan. Ask your doctor or midwife for advice.

How to take Melphalan

• Melphalan should only be given to you by a specialist doctor who is experienced in treating blood problems or cancer.
• Always take Melphalan exactly as your doctor has told you.
• It is important to take your medicine at the right times.
• The label on your pack will tell you how many tablets to take and how often to take them.
• If the label doesn’t say or if you are not sure, ask your doctor, nurse or pharmacist.
• Swallow your tablets whole with a glass of water.
• Do not break, crush or chew the tablets.
• The dose of Melphalan depends on your blood problem or cancer.
• Your doctor may also change your dose during your treatment, depending on your needs.
• The dose can sometimes be changed if you are elderly or have a kidney problem.
• When you take Melphalan, your doctor will take regular blood tests.
• This is to check the number of cells in your blood. Your doctor may sometimes change your dose as a result.

Possible side effects
* Like all medicines, Melphalan can cause side effects, although not everybody gets them.

* If you get any of the following, talk to your specialist doctor or go to hospital straight away:

* Allergic reaction, the signs may include:

• a rash, lumps or hives on the skin
• swollen face, eyelids or lips
• sudden wheeziness and tightness of the chest
• collapse (due to cardiac arrest)
• Any signs of fever or infection (sore throat, sore mouth or urinary problems)
• Any unexpected bruising or bleeding or feeling extremely tired, dizzy or breathless, as this could mean that too few blood cells of a particular type are being produced
• If you suddenly feel unwell (even with a normal temperature).

* Talk to your doctor if you have any of the following side effects which may also happen with this medicine:

Very common (affects more than 1 in 10 people)

• A drop in the number of blood cells and platelets
• feeling sick (nausea)
• being sick (vomiting) and diarrhoea
• mouth ulcers – with high doses of Melphalan
• hair loss – with high doses of Melphalan

Common (affects less than 1 in 10 people)

• hair loss – with usual doses of Melphalan
• high levels of a chemical called urea in your blood – in people with kidney problems who are being treated for myeloma

Rare (affects less than 1 in 1,000 people)

• An illness where you have a low number of red blood cells as they are being destroyed prematurely – this can make you feel very tired, breathless and dizzy and can give you headaches or make your skin or eyes yellow
  lung problems which may make you cough or wheeze and make it difficult to breathe
• liver problems which may show up in your blood tests or cause jaundice (yellowing of the whites of eyes and skin)
• mouth ulcers – with normal doses of Melphalan
• skin rashes or itching skin

The following side effects also happen with Melphalan:

• leukaemia – cancer of the blood
• In women: your periods stopping