Mechlorethamine

Your child needs to take the medicine called mechlorethamine (say: me-klor-ETH-a-meen). This information sheet explains what mechlorethamine does, how to give it, and what side effects or problems your child may have when he or she takes this medicine.

What is this medicine?

Mechlorethamine is a medicine that kills cancer cells. Mechlorethamine is also used to treat some non-cancerous conditions.

You may hear mechlorethamine called nitrogen mustard, or by its brand name, Mustargen®. Mechlorethamine comes in an injection form but can also be made into a paste or topical solution that is applied to skin to treat certain conditions. This information sheet will focus on the injection form of this drug.

Before giving this medicine to your child…

Tell your doctor if your child has ever reacted badly to mechlorethamine or any other medications, foods, preservatives, or colouring agents.

Talk with your child’s doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• has infection or recent exposure to infection (for example chickenpox)
• has low blood counts

How will your child get this medicine?

Mechlorethamine is a yellow liquid that a nurse will give by needle into your child’s vein (intravenously or IV). Your child will get this medicine in the hospital clinic or on a nursing unit.

If mechlorethamine leaks out of the vein through which it is being given, it can cause severe damage. Tell the nurse right away if you or your child notice redness, pain, or swelling at the place of injection.

What are the possible side effects of this medicine?

Your child may have some of these side effects while he or she takes mechlorethamine. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• nausea (upset stomach) and vomiting (throwing up) (usually lasts 8 to 24 hours)
• diarrhea
• hair loss
• headache
• drowsiness
• loss of appetite
• change in taste or metallic taste in mouth

Call your child’s doctor during office hours if your child has any of these side effects:

• painful rash
• dizziness
• joint pain
• loss of hearing
• ringing in ears
• swelling of feet or lower legs
• numbness, tingling, or burning of fingers, toes, or face
• sores in mouth and on lips
• yellow eyes or skin
• missed menstrual cycles (periods)

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• blood in urine or stools
• black, tarry stools
• fever or chills
• cough or hoarseness
• lower back or side pain
• pain or redness at place of injection
• painful or difficult urination
• pinpoint red spots on skin
• unusual bleeding or bruising
• shortness of breath or wheezing
• seizures (convulsions)

What safety measures should you take when your child is using this medicine?

Your child will receive other medicine to prevent upset stomach and throwing up caused by mechlorethamine.

Mechlorethamine may leave an unpleasant, metallic taste in your child's mouth. Chewing sugarless gum or sucking sugarless candy may help.

Your child may lose their hair. It will grow back once your child is no longer receiving mechlorethamine. Its colour and texture may change. Use a gentle shampoo and a soft brush.

Your child's skin may darken along the vein that mechlorethamine is given through. If this happens, it will slowly fade over time.

Mechlorethamine can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
• Avoid places that are very crowded with large groups of people.
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
• You and your child shouldn't touch your child's eyes or inside the nose without washing hands first.
• Your child’s nurse will review with you what to do in case of fever.

Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mump and rubella (MMR) and chickenpox vaccine.

Mechlorethamine can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors, or toenail clippers.
• Be careful when shaving or waxing.
• Your child should avoid contact sports where bruising or injury could occur.
• Your child should not receive a permanent tattoo or any kind of body piercing.
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking mechlorethamine.

There is a chance that mechlorethamine may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that he or she use some kind of birth control while receiving mechlorethamine. Tell the doctor right away if your child may be pregnant.

After receiving mechlorethamine your child may not be able to have children or have more difficulty having children. Your child’s doctor will discuss this in more detail with you/your child.

After your child stops receiving mechlorethamine it may still cause side effects. These delayed effects may include certain types of cancer. Your child’s doctor will be able to give you more details about this.

Check with your child’s doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

What other important information should you know?

Keep a list of all medications your child is on and show the list to the doctor or pharmacist.

Keep mechlorethamine out of your child’s sight and reach and locked up in a safe place. If your child takes too much mechlorethamine, call the Ontario Poison Centre at one of these numbers. These calls are free.

• Call 416-813-5900 if you live in Toronto.
• Call 1-800-268-9017 if you live somewhere else in Ontario.
• If you live outside of Ontario, call your local Poison Information Centre.

Disclaimer: The information in this Family Med-aid is accurate at the time of printing. It provides a summary of information about mechlorethamine and does not contain all possible information about this medicine. Not all side effects are listed. If you have any questions or want more information about mechlorethamine, speak to your health care provider.

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