Precautions and Warnings With Mechlorethamine
People who have an infection or problems with their liver or kidneys may not be able to safely use mechlorethamine. This chemotherapy drug can be an effective form of treatment, but it is not appropriate for everyone. Some of the precautions with mechlorethamine involve warnings of bone marrow problems, drug interactions, or serious infections.
What Should I Tell My Healthcare Provider?Talk with your healthcare provider prior to receiving mechlorethamine (Mustargen®) if you have:
- Kidney disease, such as kidney failure (renal failure)
- Liver disease, such as hepatitis, cirrhosis, or liver failure
- An infection of any kind
- A tumor that has spread to your bone marrow
- Low levels of white blood cells
- Low levels of platelets
- Had radiation treatment or previous chemotherapy
- Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Specific Mechlorethamine Precautions and WarningsSome warnings and precautions to be aware of prior to using this medication include the following:
- Mechlorethamine can cause significant side effects. It should only be given under the supervision of a healthcare provider who has experience using chemotherapy medicines. Your healthcare provider will weigh the risks and benefits of using this medicine before recommending treatment for your particular situation.
- This medicine is a vesicant, which is a chemical that can cause severe irritation to the skin and mucous membranes (the nose, eyes, and mouth). It could cause serious tissue damage if it leaks from the vein while you are receiving your dose. Your healthcare provider will give you the medicine in a way to help reduce contact of the medicine with the skin, nose, eyes, and mouth. If you have hardening or peeling of the skin, pain, redness, or swelling around your injection site, let your healthcare provider know immediately.
- Like other chemotherapy medicines, mechlorethamine can cause significant bone marrow depression (when the bone marrow is unable to make normal amounts of red blood cells, white blood cells, and platelets). This can lead to serious problems, including:
- People who have tumors in their bone or nervous tissue (tissue of the brain, spinal cord, and nerves) may not respond as well to this medicine.
- Your healthcare provider will monitor you closely during treatment to make sure this medicine is working for you, and to check for potentially serious side effects. You will need regular blood tests to monitor your blood cell counts, kidneys, and liver.
- This medicine can cause high levels of uric acid in the blood, which could lead to kidney stones, swelling of the joints, and a type of arthritis known as gout. It is important to stay well hydrated to help reduce the risk for these side effects. Ask your healthcare provider how much fluid you should be consuming each day.
- People with a type of leukemia known as chronic lymphatic leukemia may be more likely to develop mechlorethamine side effects, especially bone marrow depression.
- You should know that this medicine may increase your risk for developing other types of cancer. The risk may be higher when mechlorethamine is used in combination with radiation therapy or other chemotherapy.
- Mechlorethamine can decrease sperm count or cause a woman to stop menstruating (to stop having menstrual periods), which could cause infertility (the inability to have children). This side effect may be permanent.
- Mechlorethamine may react with a few other medications (see Drug Interactions With Mechlorethamine for more information).
- It is unknown if mechlorethamine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Mustargen and Breastfeeding).
- Mechlorethamine is a pregnancy Category D medication. This means it is probably not safe for use during pregnancy (see Mustargen and Pregnancy).