Pronunciation:

me-klor-ETH-a-meen

Classifications:

Pharmacologic—

Alkylating Agent

Chemical—

Nitrogen Mustard

Uses of This Medicine:

Mechlorethamine belongs to the group of medicines called alkylating agents. It is used to treat certain skin conditions that could turn to cancer if left untreated.

Mechlorethamine interferes with the growth of problem cells, which are eventually destroyed. However, there is also a chance that mechlorethamine can cause some kinds of skin cancer, especially after it has been used for several years.

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 available only with your doctor's prescription.

Before Using This Medicine:

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 this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

There is no specific information about use of mechlorethamine on the skin in children.

Older adults—

Many medicines have not been tested 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 about the use of mechlorethamine on the skin in the elderly.

Pregnancy—

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

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 taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Adenovirus Vaccine Type 4, Live
• Adenovirus Vaccine Type 7, Live
• Bacillus of Calmette and Guerin Vaccine, Live
• Influenza Virus Vaccine, Live
• Measles Virus Vaccine, Live
• Mumps Virus Vaccine, Live
• Rubella Virus Vaccine, Live
• Smallpox Vaccine
• Typhoid Vaccine
• Varicella Virus Vaccine
• Warfarin
• Yellow Fever Vaccine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of This Medicine:

Mechlorethamine may be used either as a solution or as an ointment. If you are using the solution, it must be mixed just before you use it since it breaks down quickly. Mix the solution carefully according to your doctor's or pharmacist's directions.

When preparing the solution, remember:

• Do not use the mechlorethamine if the solution is discolored or if droplets of water appear in the vial.
• Avoid inhaling the powder or any vapors. If some of the powder or solution accidentally gets on your skin, immediately wash that area of skin. Use a large amount of water and continue to wash for at least 15 minutes. If eye contact occurs, use an eyewash recommended by your doctor. Keep this eyewash on hand. Follow carefully any other instructions your doctor may have given you.
• All equipment used must be specially cleaned, even if it is to be thrown away. Follow carefully your doctor's instructions for doing this, using the special solution recommended.

Take a shower and rinse carefully just before you apply mechlorethamine solution or ointment, unless otherwise directed by your doctor. Make sure your skin is completely dry before applying the ointment. Do not shower again until the next treatment.

Apply the solution or ointment all over the body, until the entire amount for a dose is used up. Wear rubber or plastic gloves if you are using your hands. To apply the solution, a 2-inch-wide soft brush or gauze may be used instead. Let the solution dry.

Mechlorethamine should be applied more lightly to the groin, armpits, inside the bends of the elbows, and behind the knees. These areas are more likely to get irritated.

Avoid contact with the eyes, nose, or mouth, unless otherwise directed by your doctor.

Mechlorethamine is usually applied once a day. However, follow your doctor's instructions. Continue to use the medicine as long as you are told to. This may be months or years. However, do not use this medicine more often or for a longer time than ordered. To do so may increase the chance of unwanted effects.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For topical dosage forms (ointment or solution):
  • For mycosis fungoides:
    • Adults—Apply to the entire skin surface once a day. Several months after this medicine has helped your problem, your doctor may decrease the treatments to several times a week.
    • Children—Dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

The solution should not be stored but instead should be freshly made just before it is used.

Precautions While Using This Medicine:

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

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. When mechlorethamine is applied to the skin, it does not usually cause the same effects as when it is given by injection.

However, stop using this medicine and check with your doctor immediately if the following side effects occur:

Hives

shortness of breath (sudden)

skin rash or itching

sore, reddened skin

Check with your doctor also if you develop dry skin. There may be a lotion or ointment that you can use to help this. However, do not use anything else on your skin unless directed by your doctor.

Your skin color may darken after you have used this medicine for a while. The effect will go away after you have stopped using the medicine.

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

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.