You or someone close to you may be being treated for a cancer called 'Multiple Myeloma'. In such a case, your doctor may prescribe you a medicine called 'Melphalan Flufenamide'. This is actually a type of 'Chemotherapy'. The name may sound a little scary, but once you know exactly what this medicine is, it will help you to go through the treatment period more easily. Let's talk about it simply.
What exactly is this medicine?
Simply put, Melphalan Fluphenamide is a powerful drug that kills cancer cells. That is, it is a chemotherapy treatment . It is specifically used to treat multiple myeloma , a type of cancer that develops in the bone marrow. This drug is also known in the market as `Pepaxto`.
This is not a pill or capsule that you can take home. At a hospital or clinic, a doctor or a trained nursing staff will inject it into your vein through a saline line. So there's nothing to worry about, you're safe and under medical supervision.
Things you need to tell your doctor before starting treatment
To safely administer this treatment to you, your doctor needs to have a complete picture of your health. Therefore, be sure to inform him/her of the following:
| Situation you should be aware of | Why is that important? |
|---|---|
| Current infection status (e.g. fever, cough, cold, urinary tract infection) | This medicine can weaken the body's immune system. If you already have an infection, it may get worse. |
| Allergies (For this medicine, other medicines, food, drinks or dyes) | This information is essential to prevent severe allergic reactions when administering the medication. |
| Pregnancy or trying to get pregnant | This medicine can cause serious harm to the unborn baby. Therefore, you should avoid becoming pregnant during this time. |
| If a mother is breastfeeding her child | The ingredients of the medicine can pass to the baby through breast milk. Therefore, breastfeeding must be stopped during treatment. |
What happens if you take too much medicine? (Overdosage)
Since this is given in a hospital, under medical supervision, the chance of an overdose is very low. However, if you suspect that something has happened, tell your doctor or nursing staff immediately. In other cases, such as an overdose of a medicine used at home, call the National Poisons Information Centre at the Colombo National Hospital . At the same time, it is very important to go to the nearest hospital Emergency Department (ETU) as soon as possible.
What if I can't take the medicine on the scheduled day?
This treatment is given in cycles, on specific dates. So it is very important to get the treatment on the scheduled date . If for some reason you are unable to come on the scheduled date, call your doctor immediately and let him know. He will tell you what to do next.
Things to consider when undergoing treatment
Chemotherapy can be a challenging time, but if you know the facts, it can be easier to manage.
The important thing is that chemotherapy drugs affect both cancer cells and rapidly dividing healthy cells. This is why many side effects occur. So it is normal to feel uncomfortable.
1. Protect yourself from infections
This medicine can reduce the number of white blood cells in your body that fight disease. This means your immune system is weakened and you are more likely to get infections .
- If you develop symptoms such as fever, chills, sore throat, cough, or a cold , do not self-medicate and call your doctor immediately .
- Minimize your visits to crowded places (buses, trains, movie theaters) as much as possible.
- Stay away from people who are sick (fever, cough).
- Wash your hands often with soap.
2. Watch out for bleeding and bruising.
This medicine may also reduce the number of platelets, which are cells in the body that help blood clot. Therefore:
- Bruises may just appear blue on the body.
- Even a small wound can take a long time to stop bleeding .
- There is a possibility of bleeding gums and nosebleeds.
- If the stool is black or bloody, or if the vomit contains coffee grounds, it may be abnormal bleeding.
If you notice any unusual bleeding like this, tell your doctor immediately. Your doctor will often order blood tests to check your blood count during treatment.
3. Pregnancy, breastfeeding and fertility
This is a very important point.
- Women: You should completely avoid becoming pregnant while taking this medication and for 6 months after stopping treatment . Talk to your doctor about appropriate birth control.
- Men: You should also avoid fathering a child while taking this medicine and for 3 months after stopping treatment .
- Breastfeeding: Avoid breastfeeding your baby during treatment and for one week after stopping the medication.
- Fertility: This medication may affect your ability to have children in the future. If you have any concerns about this, discuss it openly with your doctor before starting treatment.
Possible side effects of the medicine
Not everyone will experience all side effects, but it's important to be aware of the possible ones.
| Side effect | Description and what to do |
|---|---|
| Serious side effects that require immediate medical attention | |
| Severe Allergic Reactions | Skin rash, itching, swelling of the face, lips or tongue, difficulty breathing. Tell your doctor immediately. |
| Signs of infection | Fever (over 100.4°F or 38°C), chills, sore throat, cough. Tell your doctor right away. |
| Abnormal bleeding | Bruising, bleeding gums/nose, black/bloody stools, dark brown/red urine. Tell your doctor immediately. |
| Decrease in red blood cells (Anemia) | Difficulty breathing, extreme fatigue, paleness, fainting. Tell your doctor immediately. |
| Side effects that are usually not serious, but if they are bothersome, you should tell your doctor. | |
| Nausea and vomiting | The doctor will give you medicine to control this. |
| Appetite | Try to eat as many nutritious foods as possible. |
| Diarrhea | Drink plenty of fluids like water and Jeevani to prevent dehydration. If it's severe, tell your doctor . |
| Headache, cough | If these persist or are bothersome, talk to your doctor. |
If you notice anything unusual that isn't on this list, don't be afraid to talk to your doctor about it.
Take-Home Message
- Melphalan Flufenamide is a chemotherapy treatment for multiple myeloma cancer that is given intravenously in the hospital.
- Before starting treatment, tell your doctor about all your health conditions, other medications you are taking, and allergies.
- Always be on the lookout for signs of infection such as fever, chills, and unusual bleeding. If you notice any of these , seek medical advice immediately.
- Avoid becoming pregnant during treatment and for a certain period of time afterwards (this applies to both women and men).
- Talk openly with your doctor about any discomfort or side effects you may experience. He or she is always ready to help you along this journey.
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