Melphalan – What It Is and When It’s Used

If you’ve heard the name melphalan, it’s probably in a cancer‑treatment conversation. Melphalan is a chemotherapy drug that belongs to the alkylating agent family. Doctors use it mainly for multiple myeloma, ovarian cancer, and some types of lymphoma. It works by attaching to DNA inside cancer cells, breaking them apart so they can’t grow or divide.

Because melafalan attacks fast‑growing cells, it also hits healthy cells that divide quickly—like those in your gut lining or hair follicles. That’s why you might notice nausea, low blood counts, or hair loss while on the medication. Knowing what to expect helps you stay a step ahead and talk confidently with your medical team.

How Melphalan Is Taken

Melafalan comes in two forms: oral tablets and an injectable solution given through a vein (IV). Your doctor decides which one fits best based on the cancer type, stage, and how you tolerate other treatments. The dosage is never “one‑size‑fits‑all.” It’s calculated from your body surface area (BSA), usually measured in milligrams per square meter (mg/m²).

Typical oral dosing for multiple myeloma ranges from 4 mg to 8 mg per day for a few days, followed by a break. IV dosing can be higher—often 0.1‑0.2 mg/kg given once every two weeks or as part of a high‑dose regimen before a stem‑cell transplant. Your oncology nurse will explain the exact schedule, and it’s crucial to follow it exactly.

If you miss a dose, don’t double up. Call your clinic; they’ll tell you whether to skip that day or adjust later doses. Keep a pill organizer or set reminders on your phone—consistency makes the drug work best and reduces side‑effect spikes.

Managing Side Effects

The most common complaints are nausea, vomiting, and low blood counts (called neutropenia). To keep nausea down, take anti‑nausea meds before each dose, stay hydrated, and eat small, bland meals. If you feel dizzy or light‑headed, sit down right away—blood pressure can dip after an infusion.

Low white‑blood‑cell counts mean you’re more prone to infections. Wash your hands often, avoid crowds when possible, and let your doctor know if you develop a fever over 100.4°F (38°C). They might pause treatment or give growth‑factor shots to boost cell production.

Hair loss can be distressing but is usually temporary. Some people wear wigs or scarves during the cycle; others simply wait it out. Your doctor can suggest scalp cooling caps if you’re worried about thinning hair.

Finally, keep a symptom diary. Write down when side effects start, how long they last, and any remedies that help. Bring this list to appointments—it gives your team concrete data to tweak doses or add supportive meds.

Melafalan isn’t a magic bullet, but when used correctly it can shrink tumors and extend survival for many patients. Understanding the drug’s purpose, how it’s taken, and ways to tame its side effects puts you in control of your treatment journey.