(mek'' lor eth' a meen )

Brand Name(s): Mustargen^®

Other Name(s): Nitrogen Mustard

IMPORTANT WARNING:

Mechlorethamine is no longer commercially available in the U.S. See the FDA website (https://www.accessdata.fda.gov/scripts/cder/daf/) for information on drugs that have been discontinued

Because this drug is no longer available in the U.S. market, this document is no longer updated by AHFS DI. If this drug is used in countries other than the U.S., it is essential that the manufacturers' labeling be consulted for more recently available information.

Mechlorethamine injection must be given under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.

Mechlorethamine is usually administered only into a vein. However, it may leak into surrounding tissue causing severe irritation or damage. Your doctor or nurse will monitor your administration site for this reaction. If you experience any of the following symptoms, call your doctor immediately: pain, itching, redness, swelling, blisters, or sores in the place where the medication was injected.

WHY is this medicine prescribed?

Mechlorethamine is used to treat Hodgkin's lymphoma (Hodgkin's disease) and certain types of non-Hodgkin's lymphoma (types of cancer that begin in a type of white blood cells that normally fights infection); mycosis fungoides (a type of cancer of the immune system that first appear as skin rashes); certain types of leukemia (cancer of the white blood cells), including chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML); and lung cancer. Mechlorethamine is also used to treat polycythemia vera (a disease in which too many red blood cells are made in the bone marrow). It is also used to treat malignant effusions (a condition when fluid collects in the lungs or around the heart) that are caused by cancerous tumors. Mechlorethamine is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Mechlorethamine comes as powder to be mixed with liquid to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. It may also be injected intraperitoneally (into the abdominal cavity), intrapleurally (into the chest cavity), or intrapericardially (into the lining of the heart). The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer or condition you have.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving mechlorethamine,

• tell your doctor and pharmacist if you are allergic to mechlorethamine, any other medications, or any of the ingredients in mechlorethamine injection. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

• tell your doctor if you have an infection. Your doctor may not want you to receive mechlorethamine.

• tell your doctor if you have previously received or will be receiving radiation (x-ray) therapy or other chemotherapy and if you have or have ever had any medical conditions..

• you should know that mechlorethamine may interfere with the normal menstrual cycle (period) in women, may stop sperm production in men, and may cause infertility (difficulty becoming pregnant). However, you should not assume that you or your partner cannot become pregnant. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not become pregnant or breast-feed while you are receiving mechlorethamine injection. Mechlorethamine may harm the fetus.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Mechlorethamine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• loss of appetite
• diarrhea
• unusual tiredness or weakness
• dizziness
• painful, swollen joints
• ringing in ears and difficulty hearing

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• fever, chills, sore throat, ongoing cough and congestion, or other signs of an infection
• unusual bleeding or bruising
• bloody or black, tarry stools
• bloody vomit
• vomited material that looks like coffee grounds
• bleeding gums
• small, round, red or purple colored spots on the skin
• hives
• rash
• itching
• difficulty breathing or swallowing
• numbness or tingling in your hands or feet
• irregular heartbeat

Mechlorethamine may increase the risk that you will develop other cancers. Talk to your doctor about the risks of receiving mechlorethamine.

Mechlorethamine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• fever, chills, sore throat, ongoing cough and congestion, or other signs of an infection
• unusual bleeding or bruising
• bloody or black, tarry stools
• bloody vomit
• vomited material that looks like coffee grounds

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to mechlorethamine.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: June 20, 2024.