In the U.S.—

In Canada—

Other commonly used names are chlormethine; nitrogen mustard.

• Antineoplastic

Mechlorethamine ( me-klor-ETH-a-meen) belongs to the group of medicines called alkylating agents. It is used to treat some kinds of cancer as well as some noncancerous conditions.

Mechlorethamine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by mechlorethamine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with mechlorethamine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Mechlorethamine is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mechlorethamine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to mechlorethamine, including a reaction if it was applied to the skin.

Pregnancy—Tell your doctor if you are pregnant or if you intend to have children. This medicine may cause birth defects if either the male or female is receiving it at the time of conception or if it is used during pregnancy. In addition, many cancer medicines may cause sterility which could be permanent. Sterility has been reported with mechlorethamine and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving mechlorethamine. Tell your doctor right away if you think you have become pregnant while receiving mechlorethamine.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because mechlorethamine may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—Although there is no specific information comparing use of mechlorethamine in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of mechlorethamine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving mechlorethamine, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines—Mechlorethamine may increase the effects of these medicines or radiation therapy on the blood

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane)—Mechlorethamine may raise the concentration of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not be as effective in patients receiving mechlorethamine

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Gout or
• Kidney stones—Mechlorethamine may increase levels of uric acid in the body, which can cause gout and kidney stones

• Infection—Mechlorethamine may decrease your body's ability to fight infection

Mechlorethamine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

Mechlorethamine often causes nausea and vomiting, which usually last only 8 to 24 hours. It is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing—

The dose of mechlorethamine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight, and whether or not other medicines are also being taken. If you are receiving mechlorethamine at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of mechlorethamine, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with mechlorethamine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Mechlorethamine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Mechlorethamine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

If mechlorethamine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the health care professional right away if you notice redness, pain, or swelling at the place of injection.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way cancer medicines act on the body, there is a chance that they might cause other effects that may not occur until months or years after these medicines are used. These delayed effects may include certain types of cancer. Discuss these possible effects with your doctor.

Check with your doctor or nurse immediately if any of the following side effects occur:

• Less common
  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness;  fever or chills;  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 
  
  

• Rare
  • Shortness of breath, itching, or wheezing 
  
  

Check with your health care professional as soon as possible if any of the following side effects occur:

• More common
  • Missing menstrual periods;  painful rash  
  
  

• Less common
  • Dizziness;  joint pain;  loss of hearing;  ringing in ears;  swelling of feet or lower legs 
  
  

• Rare
  • Numbness, tingling, or burning of fingers, toes, or face;  sores in mouth and on lips;  yellow eyes or skin 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Nausea and vomiting (usually lasts only 8 to 24 hours) 
  
  

• Less common
  • Confusion;  diarrhea;  drowsiness;  headache;  loss of appetite;  metallic taste;  weakness 
  
  

This medicine may cause a temporary loss of hair in some people. After treatment with mechlorethamine has ended, normal hair growth should return.

After you stop receiving mechlorethamine, it may still produce some side effects that need attention. During this period of time, check with your doctor if you notice any of the following side effects:

• Black, tarry stools;  blood in urine or stools;  cough or hoarseness;  fever or chills;  lower back or side pain;  painful or difficult urination;  pinpoint red spots on skin;  unusual bleeding or bruising 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, mechlorethamine is used in certain patients with the following medical conditions:

• Cancer of the lymph system (part of the immune system) that affects the skin

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.