Mechlorethamine (Mustargen)

General information

Class/mechanism: Nitrogen mustard, alkylator. Crosslinks DNA, interfering with cell replication.
Route: IV, intracavitary, topical
Extravasation: vesicant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• HIV-associated lymphoma
• Classical Hodgkin lymphoma

Diseases for which it was used

• Diffuse large B-cell lymphoma
• Follicular lymphoma

Patient drug information

• Mechlorethamine (Mustargen) patient drug information (Chemocare)
• Mechlorethamine (Mustargen) patient drug information (UpToDate)

History of changes in FDA indication

• 1949-03-15: Initial FDA approval (This is the first chemotherapy agent ever approved)
• 2004-02-09 (only label available at Drugs @ FDA):

1. "Administered intravenously, is indicated for the palliative treatment of Hodgkin's disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungoides, and bronchogenic carcinoma."
2. "Administered intrapleurally, intraperitoneally, or intrapericardially, is indicated for the palliative treatment of metastatic carcinoma resulting in effusion."

Also known as

• Generic name: chlormethine, nitrogen mustard
• Brand names: Ledaga, Mustargen, Mustine