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Evomela (injection)
Generic name: melphalan (injection)
Brand names: Evomela, Hepzato
What is Evomela?
Evomela is used to help relieve symptoms of multiple myeloma (a type of blood cancer).
Evomela injection is also used as a "conditioning" treatment for people with multiple myeloma before they have a stem cell transplant.
Evomela injection is also used to treat uveal melanoma (a type of eye cancer) in adults.
Evomela for intra-arterial use is available only from a certified pharmacy through a special program.
Evomela may also be used for reasons not mentioned in this medication guide.
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Warnings
While using Evomela, you may experience serious or life-threatening infections or bleeding more easily. Contact your doctor if you notice unusual bleeding, signs of infection (such as fever, cough, skin sores, or painful urination), flu symptoms, cough, night sweats, neck stiffness, confusion, or vision problems.
Using Evomela may raise your risk of developing other cancers. Talk to your doctor about this risk.
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Before taking this medicine
You should not use Evomela if you are allergic to it, or if you have received Evomela in the past and it did not work.
Tell your doctor if you have or have ever had:
- nausea, vomiting, or diarrhea;
- an infection or weak immune system (caused by disease or by using certain medicine);
- chemotherapy or radiation; or
- liver or kidney disease.
Using Evomela may increase your risk of developing other cancers. Ask your doctor about this risk.
You may need to have a negative pregnancy test before starting this treatment.
Evomela can harm an unborn baby if the mother or the father is using this medicine.
- If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 6 months after your last dose.
- If you are a man, use birth control if your sex partner can get pregnant. Keep using birth control for at least 3 months after your last dose.
- Tell your doctor right away if a pregnancy occurs.
Evomela may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using this medicine.
Do not breastfeed while using this medicine, and for at least 1 week after your last dose.
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Evomela side effects
Get emergency medical help if you notice signs of an allergic reaction: hives, trouble breathing, swelling of your face, lips, tongue, or throat.
Evomela may cause serious side effects. Contact your doctor immediately if you experience:
- low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough;
- low red blood cells (anemia)--pale skin, 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, difficulty swallowing or talking, dry mouth, bad breath, altered sense of taste;
- fast heart rate, low blood pressure;
- severe ongoing nausea, vomiting, or diarrhea;
- new or worsening cough, fever, difficulty breathing;
- unusual lumps;
- missed menstrual periods;
- inflammation of your blood vessels--numbness or tingling, skin rash, fever, headache, body aches, night sweats, weight loss, feeling weak or tired;
- liver problems--loss of appetite, nausea, vomiting, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
- low blood potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or feeling limp.
Common side effects of Evomela may include:
- diarrhea, nausea, vomiting;
- muscle pain, fatigue;
- mouth sores;
- tiredness;
- abnormal lab results;
- low potassium levels; or
- anemia.
This is not a complete list of side effects and others may occur. Contact your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.
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How is Evomela given?
Follow all directions on your prescription label and read all medication guides or instruction sheets.
Evomela injection is given as an infusion into a vein. A healthcare provider will give you this injection.
Some side effects may occur during the injection. Tell your medical caregiver if you feel dizzy, nauseated, light-headed, itchy, sweaty, or have a headache, chest tightness, back pain, trouble breathing, or swelling in your face.
You may be given other medications to help prevent serious side effects or allergic reaction. Keep taking these medicines for as long as your doctor has prescribed.
You may need frequent medical tests and your cancer treatments may be delayed based on the results.
You may get serious or fatal infections or bleed more easily. Your doctor will need to examine you on a regular basis.
It may take several months before your body responds to Evomela. Your doctor will determine how long to treat you with this medicine. For best results, keep using this medicine as directed. You may not get the full benefit of this medicine if you stop using it too soon.
Store Evomela in the refrigerator, do not freeze. Protect from light.
What happens if I miss a dose?
In a medical setting, you are unlikely to miss a dose.
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What happens if I overdose?
In a medical setting, an overdose would be treated quickly.
Overdose symptoms may include extreme weakness, vision problems, severe mouth sores, increased salivation or sweating, cough with mucus, shortness of breath, severe nausea and vomiting, diarrhea, bloody or tarry stools, severe stomach pain, loss of muscle movement, or seizure.
Avoid receiving a "live" vaccine. The vaccine may not work as well while you are using Evomela. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and nasal flu (influenza) vaccine.
Avoid being near people who are sick or have infections. Tell your doctor right away if you develop signs of infection.
Avoid activities that may increase your risk of bleeding or injury. Use extra care while shaving or brushing your teeth.
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What other drugs will affect Evomela?
Other drugs may impact Evomela, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform your doctor about all other medicines you are using.
This section was rewritten for readability and reviewed for meaning.
Related medicines
Content is provided for education and is not medical advice. See our medical disclaimer.