1 What is Alkeran?

Brand: Alkeran

Generic: Melphalan

Alkeran belongs to a group of medications called Alkylating agents. These medications treat cancer of the ovaries and a certain type of bone marrow cancer. Before you begin treatment with this medication, you should talk with your doctor about the risks and benefits of this medication.

This medication interferes with the growth of cancer cells, which are eventually destroyed. Because the growth of normal body cells may also be affected, other side effects will occur. Some of these may be serious and must be reported to your doctor. Other side effects may not occur for months or years after the medication is used.

Once a medication has been approved for marketing for a certain use, experience may show that it is also helpful for other medical problems.

These uses may not be listed in product labeling. However, these medications are also used in certain patients with the following medical conditions:

  • Breast cancer
  • Waldenström’s macroglobulinemia (a type of blood cancer)
  • Blood and lymph system cancer
  • Endometrium cancer
  • Malignant melanoma (a type of skin cancer that has spread to other parts of the body).

This medication is only available with your doctor’s prescription. This medication is available in the tablet form.

2 What To Know Before Using

As with all medicines, the risks of using Alkeran must be compared to how much this medication will help you. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

  • Allergies: Inform your doctor if you have ever had an allergic reaction to Doxorubicin or to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
  • Pediatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in children. However, this medication is not expected to cause different side effects or problems in children than it does in adults.
  • Geriatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in elderly patients. Safety and efficacy have not been established.
  • Pregnancy: This medication is listed as Pregnancy Category D. This means that studies in pregnant women have demonstrated a risk to the unborn child. However, the benefits of this medication in a life-threatening situation or serious disease may outweigh the potential risk.
  • Breastfeeding: There are no up-to-date studies in women for determining infant risk when using this medication while breastfeeding. Weigh the potential risks with the benefits before taking this medication while breastfeeding.
  • Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive.Using this medication with any of the following is not recommended. Your doctor may decide not to treat you with this medication, or change some of the other medications you take:
    • Rotavirus Vaccine, LiveUsing this medication with any of the following medication is not recommended, but may be unavoidable in some cases.Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:
    • Adenovirus Vaccine Type 4, Live
    • Adenovirus Vaccine Type 7, Live
    • Bacillus of Calmette and Guerin Vaccine, Live
    • Influenza Virus Vaccine, Live
    • Measles Virus Vaccine, Live
    • Mumps Virus Vaccine, Live
    • Poliovirus Vaccine, Live
    • Rubella Virus Vaccine, Live
    • Smallpox Vaccine
    • Typhoid Vaccine
    • Varicella Virus Vaccine
    • Yellow Fever VaccineUsing this medication with any of the following medications may increase your risk of side effects. However, using both medications may be the best treatment for you.If both medications are prescribed together, your doctor may change the dose or how often you take one or both medications:
    • Buthionine Sulfoximine
  • Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.
  • Other Medical Problems: Pre-existing medical problems may affect the use of this medication.Be sure to tell your doctor if you have any other medical problems, especially:
    • Bone marrow suppression
    • Leukopenia (low white blood cells in the blood)
    • Thrombocytopenia (low platelets in the blood) - May makes these conditions worse.
    • Chickenpox, including recent exposure
    • Herpes zoster (shingles) - May increases the risk of severe disease in other parts of the body.
    • Gout
    • Kidney stones - May increases uric acid levels, which can cause gout or kidney stones.
    • Infection - May decreases your body's ability to fight an infection.
    • Kidney disease - Use with caution. The effects of this medicine may be increased because of slower removal from the body.

3 Proper Usage

Only take Alkeran as directed by your doctor. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

This medication may be given with other medications. If you are using a combination of medications, it is important that you receive each one at the proper time.

If you are taking some of these medications by mouth, ask your health care professional to help you plan a way to remember to take your medication at the right times.

While using this medication, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems.

This medication may cause nausea, vomiting, and loss of appetite. It is very important to continue receiving the medication, even if you begin to feel ill. Ask your doctor for ways to lessen these effects.

If you vomit shortly after taking a dose of this medication, contact your doctor. You will be told whether to take the dose again or to wait until the next scheduled dose.


Different patients will be given a different dose of this medication based on the strength of the medication.

The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

Missed Dose

If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and resume your normal dosing schedule. Do not double dose.


Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze. Keep out of the reach of children.

Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions To Take

It is very important that your doctor checks in with you often while you are receiving Alkeran to make sure that it is working properly.

During and after treatment with Melphalan, do not have any immunizations (vaccinations) without your doctor’s approval.

This medication may lower your body’s resistance and there is a chance you may get the infection that the vaccination is meant to prevent.

Additionally, other people living in your household should not take or have taken the polio vaccine within the last several months, as there is a chance they could pass the polio virus on to you.

Avoid other people who have taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long.

If you cannot take these precautions, you should consider wearing a protective mask that covers your nose and mouth.

This medication can temporarily lower the number of white blood cells in your blood, which increases the chance of getting an infection. It can also lower the number of platelets in the blood, which are necessary for proper blood clotting.

If this occurs, there are certain precautions you can take to reduce the risk of infection or bleeding:

  • Avoid people with infections, if you are able. Inform your doctor immediately if you think you are getting an infection or if you experience a fever or chills, cough or hoarseness, lower back or side pain or painful or difficult urination.
  • Inform your doctor immediately if you notice unusual bleeding or bruising, black, tarry stool, blood in the urine or stool or red spots on the skin.
  • Be careful when using a regular toothbrush, dental floss or toothpick. Your doctor or dentist may recommend other ways to clean your teeth and gums. Inform your doctor before having any dental work done.
  • Do not touch your eyes or inside of the nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Take care not to cut yourself when using sharp objects such as a shaving razor or fingernail clippers.
  • Avoid contact sports or other situations where bruising or injury could occur.

5 Potential Side Effects

Alkeran may produce unwanted effects along with the intended 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 you experience any of the following side-effects:

Less Common

  • Black, tarry stools
  • Blood in urine or stool
  • Cough or hoarseness, accompanied by fever or chills
  • Fast or irregular heart beat (tachycardia, arrhythmias)
  • Fever or chills
  • Lower back or side pain, accompanied by fever or chills
  • Painful or difficult urination, accompanied by fever or chills
  • Red spots on skin
  • Shortness of breath
  • Skin rash or itching
  • Troubled breathing
  • Unusual bleeding or bruising


Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

Less Common

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects.

Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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