Mechlorethamine
Class: Skin and Mucous Membrane Agents, Miscellaneous
Chemical Name: 2-Chloro-N-(2-chloroethyl)-N-methylethanamine hydrochloride
Molecular Formula: CH3N(CH2CH2Cl)2•HCl
CAS Number: 55-86-7
Brands: Valchlor
Introduction
Antineoplastic agent; nitrogen mustard-derivative alkylating agent.
Uses for Mechlorethamine
Mycosis Fungoides-type Cutaneous T-cell Lymphoma (CTCL)
Topical treatment of cutaneous lesions in patients with early (stage IA and IB) mycosis fungoides-type CTCL who have received prior skin-directed therapy. Designated an orphan drug by FDA for use in this condition.
Expert treatment guidelines include topical mechlorethamine as one of several recommended treatment options for patients with early stages of mycosis fungoides-type CTCL.
Mechlorethamine Dosage and Administration
Administration
Topical Administration
Apply to skin as commercially available 0.016% mechlorethamine gel.
Has been applied to skin as aqueous solution or ointment-based preparation compounded extemporaneously using mechlorethamine hydrochloride for injection.
For topical dermatologic use only. Do not use near or in the eyes, nose, or mouth. (See Mucosal or Eye Injury under Cautions.)
Wash hands thoroughly with soap and water after handling or applying the drug. (See Warnings/Precautions under Cautions.)
Application by Caregiver
Manufacturer states caregiver must wear disposable nitrile gloves during application and wash hands thoroughly with soap and water after removing the gloves.
In case of accidental skin exposure, immediately wash exposed areas thoroughly with soap and water for ≥15 minutes and remove contaminated clothing.
In case of accidental exposure to eyes, mouth, or nose, immediately irrigate exposed area for ≥15 minutes with copious amounts of water.
Gel
Apply gel immediately (or within 30 minutes) after removal from refrigerator; return gel to refrigerator immediately after each use.
Apply gel to completely dry skin ≥4 hours before or ≥30 minutes after showering or washing affected areas. After application, allow treated areas to dry for 5–10 minutes before covering with clothing.
May apply emollients (moisturizers) to treated areas 2 hours before or 2 hours after application of the gel.
Do not use occlusive dressings on treated areas.
Avoid fire, flame, and smoking until gel has dried.
Extemporaneously Compounded Ointment
Usually prepared by dissolving mechlorethamine hydrochloride in dehydrated alcohol, filtering the solution to remove insoluble sodium chloride present in the commercial preparation (although filtration may not be necessary), and mixing the drug-alcohol solution into petrolatum or another anhydrous ointment base (e.g., hydrophilic petrolatum). Usual mechlorethamine hydrochloride concentration is 0.01 or 0.02%. Consult specialized references for detailed information on preparation of topical ointments.
