Melphalan — What It Is, How It Works, and What to Expect

If you’ve been prescribed melphalan, you’re probably wondering what the drug does and why your doctor chose it. In short, melphalan is an alkylating chemotherapy agent. It attaches to DNA in fast‑growing cells, stops them from dividing, and eventually leads to cell death. That’s why it’s useful for cancers that grow quickly, like multiple myeloma, ovarian cancer, and certain types of leukemia.

Melphalan isn’t a one‑size‑fits‑all pill. Doctors decide the dose based on your weight, kidney function, and the specific cancer you’re treating. It can be taken as a capsule or given intravenously, and the schedule may be every few weeks or monthly, depending on your treatment plan.

When Doctors Choose Melphalan

Typical scenarios include:

• Multiple myeloma: Often part of a combination regimen after a stem‑cell transplant.
• Ovarian cancer: Used when the disease comes back after surgery or other chemo.
• Chronic leukemia: Sometimes added when standard drugs aren’t enough.

Because melphalan targets rapidly dividing cells, it also affects healthy cells in your bone marrow, digestive tract, and hair follicles. That’s why you’ll hear about side effects like low blood counts, nausea, and hair loss.

Dosage, Side Effects, and Safety Tips

Dosage basics: Most adults get between 0.1 mg/kg and 0.5 mg/kg per cycle. Your oncologist will calculate the exact amount and tell you how often to take it. Never try to change the dose on your own; even a small adjustment can swing the balance between effectiveness and toxicity.

Common side effects: Expect some nausea, fatigue, and a drop in white blood cells (called neutropenia). You might also notice sore mouth, loss of appetite, or temporary hair thinning. Most of these symptoms peak a few days after the dose and improve with supportive care.

What to watch for: If you develop fever, chills, or a sore throat, call your clinic right away—these can signal an infection when your blood counts are low. Persistent vomiting, severe diarrhea, or sudden swelling should also be reported.

Staying safe: Keep a notebook of your blood test results; doctors use them to decide when it’s safe to give the next cycle. Stay hydrated, eat small frequent meals, and consider anti‑nausea meds that your doctor prescribes. If you’re prone to low platelet counts, avoid activities that could cause cuts or bruises.

Another practical tip: ask your pharmacist about drug interactions. Over‑the‑counter meds, herbal supplements, and even some vitamins can interfere with melphalan’s metabolism.

Finally, remember that emotional support matters. Talking to a counselor, joining a cancer‑patient group, or simply sharing your feelings with friends can make the treatment journey less isolating.

Melphalan can be a powerful tool in the fight against certain cancers, but it works best when you understand how to take it, what side effects to anticipate, and how to manage them. Keep the lines of communication open with your oncology team, follow the dosing schedule exactly, and monitor your body’s signals. With the right plan, you give yourself the best shot at a successful outcome.