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Mechlorethamine is a drug which is used to treat many kinds of cancer. It
is usually given by intravenous injection, but may also be injected into
body cavities.
EARLY SIDE EFFECTS: Vomiting may occur 1-3 hours after treatment, and may
last for 8 hours. Nausea may persist for 24 hours. Some patients
experience little nausea. An injection of antinauseant may be given when
you receive your chemotherapy. In addition, the physician may give you a
prescription for antinausea medication, which should be taken as
directed. Antinausea medication is more effective when used to prevent
nausea, than when used to treat it after it has occurred. Appropriate
food choices can help to control your nausea. Some patients notice a
metallic taste that is unpleasant. Sucking or chewing cinnamon or
peppermint candy or gum may help mask this taste. Mechlorethamine can
cause burning if it leaks into the skin and tissue surrounding the
injection site. If you notice burning, stinging or any change in
sensation while the drug is being given, notify the nurse or physician
immediately. Injection of mechlorethamine into a body cavity such as the
chest may cause some pain and/or discomfort. You will be given medication
for pain prior to this treatment. Notify the nurse or physician if pain
becomes worse.
DELAYED SIDE EFFECTS: White blood cells (that fight infection) and
platelets (that help your blood to clot) may be decreased 7-14 days after
you have received your treatment. This is a normal and expected response
to chemotherapy and the blood counts will return to normal levels over
time. Regular blood tests are done to monitor your blood counts.
The vein in which mechlorethamine was injected may be sore after the
injection. The application of ice may relieve the pain. The arm should be
moved and used as much as is comfortable, to avoid hardening of the vein.
Other medications may interact with mechlorethamine. Do not start taking
new medications without first checking with your physician or pharmacist.
For minor pain, take acetaminophen (Tylenol). Do not take ASA (Aspirin) or
ibuprofen (Advil). Inform new physicians or dentists that you have had
mechlorethamine before you receive any treatment from them.
Use birth control while being treated with mechlorethamine. Do not breast
feed during treatment.
NOTIFY YOUR PHYSICIAN IMMEDIATELY IF ANY OF THE FOLLOWING OCCUR:
- Signs or symptoms of an infection such as fever, sore throat,
cold symptoms, cough, pain or burning on urination, redness, pain,
or swelling of any areas of the body, ulceration or abscess (pus)
forming anywhere on the body.
- Easy bleeding or bruising.
Notify your physician as soon as possible during office hours
if you have:
- signs of kidney problems such as lower back pain, swelling of feet
or lower legs, numbness or tingling in your feet or hands.
- signs of gout such as joint pain.
Check with your physician if these continue to bother you:
- Redness, inflammation, pain or failure to heal at the site of the
injection.
- Uncontrolled nausea, vomiting or diarrhea.
REPORT ADDITIONAL PROBLEMS TO YOUR PHYSICIAN.
PATIENT INFORMATION FOR TOPICAL ADMINISTRATION:
To mix the solution:
- Mix the solution just before you need it because it breaks down
quickly. Each vial of mechlorethamine (nitrogen mustard, Mustargen)
contains ten milligrams (10 mg) of powder.
You will need a wide-mouthed mixing jar with a screw-on lid.
- Put 45-60 mL (3-4 tablespoons) water in the jar.
Draw a line at the top of the water with a marking pen.
There should be enough water to cover your entire skin once.
Empty the jar.
- Remove the rubber stopper from the drug vial.
- Pour 5-10 mL (1-2 teaspoons) tap water into the drug vial.
Swirl gently to dissolve.
- Pour the drug solution into the mixing jar.
- Rinse the vial with 5-10 mL water and add the rinse to the
mixing jar. Repeat.
- Add water to the line on the mixing jar.
- Tightly cap the mixing jar and shake well.
Using your palms, apply the mechlorethamine to the entire body surface
whether involved by disease or not. This includes scalp, eyelids, groin and
between the toes. You may also use a soft paint brush or gauze to apply the
solution. If any mechlorethamine solution remains after one coating, then
start again until the entire mixture has been applied.
If your skin becomes dry, 5-15 mL (1-3 teaspoonsful) of an emulsified bath
oil or glycerin may be added to the mixture before adding water to the line
on the mixing jar. Rinse the mixing jar, brush and gloves (if used)
immediately after use. Store them away from kitchen equipment and use only
for mixing and applying mechlorethamine.
Remember these points to reduce potential irritation:
- Avoid getting mechlorethamine in your eyes, nose or mouth unless
directed by your physician. Keep the eyes closed when applying the
mixture on the face.
If they come into contact with mechlorethamine, rinse thoroughly
with lots of water.
- Apply the mechlorethamine solution once lightly to the
intertriginous areas, i.e. under the arms, beneath the breasts and
in the groin. The skin here is thinner and may become irritated if
too much mechlorethamine solution is applied.
- Avoid breathing the powder.
- Wash the hands after application to remove excess mechlorethamine.
Rubber gloves are not usually necessary, but may be worn if
irritation develops between the fingers.
The mechlorethamine solution may be applied at any time during the day. A
convenient time is after bathing.
Assistants should wear gloves to avoid any irritation by the solution.
Unnecessary exposure to mechlorethamine solution should be avoided e.g. by
other members of the household. Reserve containers and equipment used to
prepare and apply the solution only for that purpose.
Should you have any questions or problems, contact your physician.
