The dosage must be individualised by doctor for each patient depending on disease, severity, age and weight of patient.
It must not be used in pregnancy, breastfeeding or children unless essential for the life of the child. Use with caution in kidney disease and if given radiation or cytotoxic treatment recently. Regular blood tests to check blood cells are essential.
Side effects may include:
- damage to bone marrow and white blood cells,
- sore mouth,
- hair loss,
- lung damage,
- rarely, severe abnormal bleeding or bruising.
Melphalan interacts with cyclosporin and nalidixic acid. An overdose is very serious with destruction of bone marrow possible, which may lead to fatal infections.