Mechlorethamine
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Contents |
Introduction
- Tradename: Mustargen.
Indications
- brain tumors
- Hodgkin's disease
- non-Hodgkin's lymphoma
- chronic leukemias
- malignant effusions (intracavitary injections)
- mycosis fungoides
- palliative treatment of:
Contraindications
- severe myelosuppression
- infection
Dosage
- Hodgkin's lymphoma: 6 mg/m2 IV on days 1 & 8, repeated monthly
- as single agent: 0.4 mg/kg/month
- intracavitary: 0.4 mg/kg
- topically: 0.17 mg/mL applied daily
- Powder for injection: 10 mg.
Pharmacokinetics
- elimination via plasma
Adverse-effects
- common (> 10%)
- bone marrow suppression (dose-related)
- leukopenia & thrombocytopenia may be severe
- onset: 4-7 days
- nadir: 14 days
- recovery: 21 days
- moderate to severe nausea/vomiting
- reproductive dysfunction
- amenorrhea (may be temporary or pemanent)
- impaired spermatogenesis (may return to normal after several years)
- chromosomal abnormalities
- less common (1-10%)
- thrombosis, diarrhea, anorexia, metallic taste, secondary malignancies*, thrombophlebitis, tissue necrosis with extravasation#
- uncommon (< 1%)
- other
- * secondary malignancies occur in 1-6% of patients after several years
- # sodium thiosulfate is a specific antidote for nitrogen mustard extravasations
Test-interactions
- increases serum K+
Mechanism-of-action
- alkylating agent
- interferes with DNA & RNA synthesis Mechanism of drug resistance:
- defective transport via the choline transporter
More General Terms
Additional Terms
Internet Database
References
- Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- Kaiser Permanente Northern California Regional Drug Formulary, 1998
- Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 533
