Mechlorethamine Hydrochloride (HN2, Nitrogen Mustard)(me klor eth’ a meen)
Mustargen, Valchlor
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Nitrogen mustard
Therapeutic Actions
Cytotoxic: Reacts chemically with DNA, RNA, other proteins to prevent replication and function of susceptible cells, causing cell death; cell-cycle nonspecific.
Indications
IV use: Palliative treatment of bronchogenic carcinoma, Hodgkin disease, lymphosarcoma, chronic myelogenous leukemia, chronic lymphocytic leukemia, mycosis fungoides, polycythemia vera
Intrapleural, intraperitoneal, intrapericardial use: Palliative treatment of effusion secondary to metastatic carcinoma
NEW INDICATION: Treatment of stage 1A and 1B mycosis fungoides–type cutaneous T-cell lymphoma in patients who have received prior skin-directed therapy
Unlabeled uses: Non-Hodgkin lymphoma, lymphoma, brain tumors
Contraindications and Cautions
Contraindicated with allergy to mechlorethamine, active infection, pregnancy, lactation.
Use cautiously with amyloidosis, hematopoietic depression, concomitant steroid therapy.
Available Forms
Powder for injection—10 mg; gel—0.016%
Indications
Individualize dosage based on hematologic profile and response.
Dosages
Adults
IV
Usual dose, total of 0.4 mg/kg IV for each course of therapy as a single dose or in two to four divided doses of 0.1–0.2 mg/kg/day. Give at night in case sedation is required for side effects. Interval between courses of therapy is usually 3–6 wk.
Intracavitary
Dose and preparation vary greatly with cavity and disease treated. Consult manufacturer’s label; usual dose 0.2–0.4 mg/kg.
Topical
Apply thin film once daily to affected areas of skin. Avoid eyes and mucous membranes.
Pharmacokinetics
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