Mechlorethamine Nitrogen Mustard

Mechlorethamine Nitrogen Mustard Brand Names- Mustargen | VALCHLOR

What is Mechlorethamine Nitrogen Mustard

Mechlorethamine is a bifunctional alkylating chemotherapy agent. Intravenous mechlorethamine is indicated to treat many malignancies including Hodgkin lymphoma, chronic lymphocytic leukemia, chronic myelogenous leukemia, and mycosis fungoides; it has also been used via intracavitary administration to treat malignant pleural effusions.

Mechlorethamine for injection was discontinued by the manufacturer due to extremely low demand of the product in December 2018.

Mechlorethamine topical gel is indicated for the treatment of stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma in patients who have received prior skin-directed therapy.

Avoid mechlorethamine exposure to mucous membranes; ocular exposure may result in severe injury or blindness.

Indications

  1. chronic lymphocytic leukemia (CLL)
  2. chronic myelogenous leukemia (CML)
  3. cutaneous T-cell lymphoma (CTCL)
  4. Hodgkin lymphoma
  5. lung cancer
  6. mycosis fungoides
  7. pericardial effusion
  8. peritoneal effusion
  9. pleural effusion
  10. polycythemia vera

For the treatment of chronic lymphocytic leukemia (CLL)

Side Effects

  1. agranulocytosis
  2. alopecia
  3. amenorrhea
  4. anaphylactoid reactions
  5. anemia
  6. anorexia
  7. azoospermia
  8. bleeding
  9. diarrhea
  10. erythema multiforme
  11. exfoliative dermatitis
  12. GI bleeding
  13. gonadal suppression
  14. hearing loss
  15. hemolytic anemia
  16. hyperuricemia
  17. immunosuppression
  18. infection
  19. infection
  20. infertility
  21. injection site reaction
  22. jaundice
  23. leukopenia
  24. lymphopenia
  25. maculopapular rash
  26. nausea
  27. neutropenia
  28. new primary malignancy
  29. oligomenorrhea
  30. pancytopenia
  31. petechiae
  32. phlebitis
  33. pruritus
  34. pruritus
  35. skin hyperpigmentation
  36. skin ulcer
  37. spermatogenesis inhibition
  38. thrombocytopenia
  39. thrombosis
  40. tinnitus
  41. tissue necrosis
  42. vertigo
  43. vomiting
  44. weakness

Monitoring Parameters

  • CBC with differential
  • serum uric acid

Contraindications

  • accidental exposure
  • anemia
  • bleeding
  • bone marrow suppression
  • breast-feeding
  • children
  • contraception requirements
  • dental disease
  • dental work
  • extravasation
  • herpes infection
  • hyperuricemia
  • immunosuppression
  • infants
  • infection
  • infertility
  • inflammation
  • leukopenia
  • male-mediated teratogenicity
  • neonates
  • neutropenia
  • new primary malignancy
  • ocular exposure
  • pregnancy
  • radiation therapy
  • reproductive risk
  • requires an experienced clinician
  • skin disease
  • suppurative inflammation
  • thrombocytopenia
  • tumor lysis syndrome (TLS)
  • varicella
  • viral infection

Interactions

  • Aldesleukin, IL-2
  • Amlodipine; Celecoxib
  • Celecoxib
  • Clozapine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Flucytosine
  • Flurbiprofen
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Penicillamine
  • Piroxicam
  • Rofecoxib
  • Sulindac
  • Tolmetin
  • Tuberculin Purified Protein Derivative, PPD
  • Valdecoxib