Melphalan is used as a "palliative" treatment to relieve symptoms of multiple myeloma (a type of blood cancer) or a certain type of ovarian cancer.

Melphalan injection is used as a "conditioning" treatment for multiple myeloma before you receive a stem cell transplant.

Melphalan may also be used for purposes not listed in this medication guide.

You should not use melphalan if you are allergic to it, or if you received this medicine in the past and it did not work.

Tell your doctor if you now have or have ever had:

• nausea, vomiting, or diarrhea;
• an infection or weak immune system (caused by disease or by using certain medicine);
• liver or kidney disease; or
• chemotherapy or radiation.

Using melphalan may increase your risk of developing other cancers, such as leukemia. Ask your doctor about this risk.

Both men and women using this medicine should use effective birth control to prevent pregnancy during and shortly after treatment. Melphalan can harm an unborn baby or cause birth defects if the mother or father is using this medicine.

Ask your doctor how long you should keep using birth control after your last dose of melphalan. Tell your doctor right away if a pregnancy occurs while either the mother or the father is using melphalan.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because melphalan can harm an unborn baby.

You should not breastfeed while using melphalan.

Use Evomela (Intravenous) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives, itching, skin redness; blurred vision, feeling light-headed; fast heartbeats; trouble breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• low white blood cell counts--fever, chills, cough, pain or burning when you urinate.
• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet;
• easy bruising, unusual bleeding, purple or red spots under your skin;
• sores or white patches in or around your mouth, trouble swallowing or talking, dry mouth, bad breath, altered sense of taste;
• severe ongoing nausea, vomiting, or diarrhea;
• new or worsening cough, fever, trouble breathing;
• unusual lumps or masses;
• missed menstrual periods;
• inflammation of your blood vessels--warmth or tingling, skin rash, fever, headache, body aches, night sweats, weight loss, feeling or weak or tired;
• liver problems--loss of appetite, stomach pain (upper right side), dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
• low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

• low blood cell counts;
• mouth sores;
• tiredness;
• low potassium levels; or
• hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do not receive a "live" vaccine while using melphalan. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.