How does this medication work? What will it do for me?

Mechlorethamine is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Mechlorethamine belongs to a class of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as alkylating agents. Mechlorethamine prevents the growth of cancer cells by interfering with the genetic material DNA, which is necessary for reproduction of cells.

It is used in combination with other antineoplastic medications to treat a type of cancer called Hodgkin's disease.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Mustargen is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The recommended dose of mechlorethamine varies according to the response to therapy, the other medications being used, and the body weight of the person receiving it.

It is available as an intravenous (into the vein) injection. It is usually injected through a specially-prepared site on the skin. The dosing regimen for this medication varies widely, but often a "course" of 0.4 mg per kg of body weight is given in one injection or as divided doses of 0.1 mg to 0.2 mg per kg per day. Courses can be repeated after the person has recovered from a previous course, which is usually a minimum of 3 weeks.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Very careful handling of this medication is required. It is always given by a doctor or someone under direct supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive mechlorethiamine, contact your doctor as soon as possible to reschedule your appointment.

As well as interfering with the genetic material DNA of cancer cells, mechlorethamine can interfere with some of your normal cells. This can cause a number of side effects such as hair loss and mouth sores. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take mechlorethamine if you:

  • are allergic to mechlorethamine or any ingredients of the medication
  • have an active infection

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • confusion
  • diarrhea
  • drowsiness
  • headache
  • loss of appetite
  • metallic taste in mouth
  • nausea and vomiting, usually lasting between 8 and 24 hours
  • temporary loss of hair (returns after treatments end although texture or colour may change)
  • weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • dizziness or sensation of spinning
  • joint pain
  • loss of hearing
  • missed menstrual periods
  • painful rash
  • numbness, tingling, or burning in fingers, toes, or face
  • ringing in ears
  • sores in mouth and on lips
  • swelling of feet or lower legs
  • yellow eyes or skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • black, tarry stools or blood in stools or urine
  • cough or hoarseness
  • fever or chills
  • itching, wheezing, shortness of breath
  • lower back or side pain
  • pain or redness at place of injection
  • painful or difficult urination
  • pinpoint red spots on skin
  • unusual bleeding or bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor about any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.

Gout: This medication may cause high levels of uric acid in the blood, making gout more likely to occur.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills.

Sperm counts: When taken by men, this medication may reduce sperm counts or cause sperm production to stop entirely, especially when used in conjunction with other chemotherapy medications. In some cases sperm production may resume after treatment, but this may happen only several years after intensive chemotherapy has been stopped.

Pregnancy: This medication may harm the baby if used during pregnancy (especially during the first trimester). It is best to use an effective method of birth control to avoid pregnancy while being treated with mechlorethamine. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if mechlorethamine passes into breast milk. Because mechlorethamine could cause serious problems for the baby if it did pass into breast milk, women taking this medication should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between mechlorethamine and any of the following:

  • amphotericin B
  • azathioprine
  • chloramphenicol
  • colchicine
  • echinacea
  • flucytosine
  • ganciclovir
  • interferon
  • live vaccinations
  • natalizumab
  • pimecrolimus
  • plicamycin
  • probenecid
  • roflumilast
  • medications for overactive thyroid
  • other cancer medications
  • sulfinpyrazone
  • tacrolimus ointment
  • zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.