What Is Alkeran® (Melphalan)?

A type of chemotherapy medication, Alkeran (melphalan), is also referred to as L-phenylalanine mustard, phenylalanine mustard, L-Pam, or L-sarcolysin. Melphalan is a type of anti-cancer drug that’s classified as an alkylating agent. This means it works by interfering with cell DNA and stopping the cancer cell’s ability to divide.

Alkeran is generally used as a form of palliative treatment for patients with certain types of cancers in the abdomen and other regions. Alkeran has also been used in combination with heat to effectively slow tumor growth in patients with peritoneal mesothelioma. This therapy is meant to help reduce symptoms and slow the spread of tumors. Other treatment methods must be employed for curative care, such as cytoreductive surgery in patients with mesothelioma.

What is Alkeran Used for?

Doctors administer it to the patient in pill form. The patient will generally get 2mg tablets they must take orally. It’s advised the patient take the medication on an empty stomach, approximately 1 hour before or 2 hours after they plan to eat. Alkeran can also be given intravenously (injection to the vein).

Your doctor or healthcare provider will determine the amount of Alkeran to incorporate into the patient’s treatment based on a few factors. These include the patient’s overall health, stage, and type of mesothelioma (or other cancer).

This is an image representing nausea.

Side-Effects of Alkeran (Melphalan) Treatment

All medications and treatments will have some form of side-effects associated. While most side-effects are manageable, if they become too difficult for a patient, a medical professional can prescribe additional medications to help relieve the effects. Some side-effects of Alkeran include:

  • Low platelet count (inability for blood to clot)
  • Low red blood cell count (anemia)
  • Low white blood cell count (more prone to infections)
  • Nausea and vomiting

Less common side-effects that occur in less than 30% of patients are:

  • Allergic reaction (less than 10% of patients)
  • Sores in the mouth
  • Diarrhea
  • Hair loss

Seek emergency help if you experience following side-effects:

  • Blocked airways in the throat
  • Coughing or wheezing
  • Facial swelling
  • Hives
  • Shortness of breath
  • Trouble breathing

Alkeran also brings slight risks of delayed effects like kidney or heart problems, infertility, or the development of blood cancers. Your doctor will monitor health during treatment to make sure side-effects are under control and that your blood count and organ functions are well.

This is an image representing the precautions that needed to be taken prior to chemotherapy.

Treatment Precautions

To ensure that treatment goes smoothly, patients must take certain precautions before taking Alkeran. Some precautions to consider before, during, or after being treated :

  1. Keep your doctor informed on any other medications, prescriptions, over-the-counter, vitamins, herbal remedies, or anything else you may take well before treatment begins.
  2. Avoid any immunization or vaccination without consent from your doctor while in treatment
  3. Tell your doctor if you’re pregnant or breastfeeding before taking Alkeran. Avoid breastfeeding or conceiving a child while on chemotherapy.

Melphalan can have adverse reactions when combined with other therapies. Avoid being surprised by disclosing everything to your doctor and following their recommendations.

This is an image representing self care - specifically good nutrition.


It’s essential to take care of yourself during treatment because your body will be weak and prone to infection. Some steps to take to help you maintain during treatment are:

  • Avoid crowds or sick people
  • If you get nauseous, eat small frequent meals and suck on a lozenge or chew gum
  • Little to no alcohol consumption
  • Maintain good nutrition
  • Minimize sun exposure and wear sunscreen
  • Stay hydrated and drink a lot of fluids as recommended
  • Use a soft toothbrush to prevent mouth sores
  • Stay away from contact sports or physical activities that can cause injury
  • When shaving, use an electric razor to minimize bleeding
  • Wash hands thoroughly and often

These tips can help improve a patient’s quality of life while taking Alkeran. Your doctor may have more specific recommendations for you.

Talk to a Doctor About Alkeran

Your doctor will have an abundance of resources about the process of taking Alkeran or melphalan for chemotherapy. They will set up a specific schedule for dosage that is unique to your health needs to help keep you on track.

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