Melphalan: What It Is and How It’s Used

If you’ve ever heard a doctor mention melphalan, they’re talking about an older chemotherapy drug that belongs to the alkylating agent family. In simple terms, it works by attaching itself to DNA inside cancer cells and stopping those cells from multiplying. That’s why doctors often choose it for cancers that grow quickly, like multiple myeloma or certain types of ovarian and breast tumors.

Common Uses and Dosage Forms

Melphalan usually comes as a tablet you swallow or a liquid you inject intravenously. The exact dose depends on your weight, the type of cancer, and how well your kidneys are working. For multiple myeloma, patients might take a pill once a day for several days each month, then have a break to let their bodies recover. If it’s given by IV, the infusion happens over a few minutes in a clinic. Your doctor will decide which method fits you best and will adjust the schedule if you experience strong side effects.

Side Effects and Safety Tips

Like any chemo drug, melphalan can cause unwanted reactions. The most common ones are nausea, vomiting, low blood counts, and mouth sores. Keep an eye on any fever or unusual bleeding because those could signal a drop in white cells or platelets. Staying hydrated, eating soft bland foods, and using prescribed anti‑nausea meds can make the experience easier.

Before you start melphalan, tell your doctor about all other medicines you take, especially antibiotics, blood thinners, or supplements that affect kidney function. Pregnant or breastfeeding women should avoid it unless a specialist says otherwise, as it can harm the baby. If you’re scheduled for surgery, let your surgeon know you’re on melphalan so they can plan around the low‑blood‑count period.

Monitoring is key. Your medical team will likely order blood tests every week or two to check counts and kidney health. When numbers dip too low, they might pause treatment until you bounce back. That pause feels frustrating, but it protects you from infections and more serious problems.

Finally, don’t skip follow‑up appointments. Even after the last dose, doctors often keep an eye on patients for months to catch any late‑emerging side effects or signs of cancer returning. If you notice new symptoms—persistent fatigue, unusual bruising, or a sudden rash—reach out right away.

Melphalan isn’t a one‑size‑fits‑all drug, but for many people it’s an effective part of the fight against aggressive cancers. Understanding how it works, what to expect, and how to stay safe can make the treatment journey smoother and give you more confidence in managing your health.