Melphalan: uses, dosing, side effects & brands
Melphalan is an alkylating drug sold in the U.S. under 5 brand and generic names, for breast neoplasms, multiple myeloma and neuroblastoma. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Alkylating Drug
- Treats (across its forms)
- Breast Neoplasms, Multiple Myeloma and Neuroblastoma
- Available as
- Tablet · Injectable · Kit
- Sold as
- 5 products — Alkeran, Ivra and Evomela, and others
- Prescription?
- Prescription only
- Generic available?
- Yes
- Boxed warning
- Boxed warning
How Melphalan Hydrochloride is dosed
From the FDA label for Melphalan Hydrochloride (application ANDA211463). Other melphalan products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
The usual IV dose is 16 mg/m 2 . Dosage reduction of up to 50% should be considered in patients with renal insufficiency (BUN ≥30 mg/dL) (see PRECAUTIONS, General ). The drug is administered as a single infusion over 15 to 20 minutes. Melphalan is administered at 2-week intervals for 4 doses, then, after adequate recovery from toxicity, at 4-week intervals. Available evidence suggests about one third to one half of the patients with multiple myeloma show a favorable response to the drug. Experience with oral melphalan suggests that repeated courses should be given since improvement may continue slowly over many months, and the maximum benefit may be missed if treatment is abandoned prematurely. Dose adjustment on the basis of blood cell counts at the nadir and day of treatment should be considered. Administration Precautions As with other toxic compounds, caution should be exercised in handling and preparing the solution of Melphalan Hydrochloride for Injection. Skin reactions associated with accidental exposure may occur. The use of gloves is recommended. If the solution of Melphalan Hydrochloride for Injection contacts the skin ormucosa, immediately wash the skin or mucosa thoroughly with soap and water. Procedures for proper handling and disposal of anticancer drugs should be considered. Several guidelines on this subject have been published. 1-4 There is no general…
Everything below is the FDA label for Melphalan Hydrochloride (kit). Melphalan is also sold as tablet and injectable, and those are different medicines to take — follow the label for the one you were prescribed.
Melphalan Hydrochloride side effects
(SEE OVERDOSAGE) The following information on adverse reactions is based on data from both oral and IV administration of melphalan as a single agent, using several different dose schedules for treatment of a wide variety of malignancies. Hematologic The most common side effect is bone marrow suppression leading to leukopenia, thrombocytopenia, and anemia. White blood cell count and platelet count nadirs usually occur 2 to 3 weeks after treatment, with recovery in 4 to 5 weeks after treatment. Irreversible bone marrow failure has been reported. Gastrointestinal Gastrointestinal disturbances such as nausea and vomiting, diarrhea, and oral ulceration occur infrequently. Hepatic disorders ranging from abnormal liver function tests to clinical manifestations such as hepatitis and jaundice have been reported. Hepatic veno-occlusive disease has been reported. Hypersensitivity Acute hypersensitivity reactions including anaphylaxis were reported in 2.4% of 425 patients receiving Melphalan Hydrochloride for Injection for myeloma (see WARNINGS ). These reactions were characterized by urticaria, pruritus, edema, skin rashes, and in some patients, tachycardia, bronchospasm, dyspnea, and hypotension. These patients appeared to respond to antihistamine and corticosteroid therapy. If a hypersensitivity reaction occurs, IV or oral melphalan should not be readministered since hypersensitivity…
Who shouldn’t take Melphalan Hydrochloride
Melphalan should not be used in patients whose disease has demonstrated prior resistance to this agent. Patients who have demonstrated hypersensitivity to melphalan should not be given the drug.
Melphalan Hydrochloride drug interactions
The development of severe renal failure has been reported in patients treated with a single dose of IV melphalan followed by standard oral doses of cyclosporine. Cisplatin may affect melphalan kinetics by inducing renal dysfunction and subsequently altering melphalan clearance. IV melphalan may also reduce the threshold for BCNU lung toxicity. When nalidixic acid and IV melphalan are given simultaneously, the incidence of severe hemorrhagic necrotic enterocolitis has been reported to increase in pediatric patients.
Every melphalan product we track (5)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 66/100 | Prescription | Tablet | No data | — | View → | |
| 2 | 66/100 | Prescription | Injectable | No data | — | View → | |
| 3 | Not yet rated | Prescription | Injectable | No data | — | View → | |
| 4 | Not yet rated | Prescription | Kit | No data | — | View → | |
| 5 | Not yet rated | Prescription | Kit | No data | — | View → |
What people report to the FDA about melphalan
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 2,529 reports naming melphalan, and the FDA flagged 97% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- pyrexia141 reports
- mucosal inflammation137 reports
- neutropenia122 reports
- febrile neutropenia116 reports
- diarrhoea111 reports
- pneumonia107 reports
- thrombocytopenia107 reports
- sepsis106 reports
Read these as a signal, not a rate. A report does not mean melphalan caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label.
Source: openFDA drug/event (FAERS), retrieved September 25, 2026.
Related calculators
Frequently asked questions
What is Melphalan Hydrochloride?
Melphalan, also known as L-phenylalanine mustard, phenylalanine mustard, L-PAM, or L-sarcolysin, is a phenylalanine derivative of nitrogen mustard. Melphalan is a bifunctional alkylating agent that is active against selected human neoplastic diseases.
What kind of drug is melphalan?
The FDA classifies melphalan as an alkylating drug. Alkylating chemotherapy drugs attach chemical groups to a cell's DNA, forming cross-links that lock the two DNA strands together. This damage stops the cell from copying its DNA and dividing, which triggers it to die; because they are not limited to one phase of the cell cycle, they can act on cells whether or not they are actively dividing. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take melphalan with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run melphalan against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is melphalan sold under?
We track 5 melphalan-containing products in the U.S.: Alkeran, Ivra, Evomela, Hepzato and Melphalan Hydrochloride. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does melphalan come in?
Across the brands we track, melphalan is currently marketed as tablet, injectable and kit, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic melphalan?
Yes. Our catalog lists 1 generic melphalan product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Melphalan: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/melphalan
- MLA
- “Melphalan: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/melphalan.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for melphalan on DailyMed (NIH) ↗ — including its boxed warning in full.