Mustargen

Mustargen is a type of chemotherapy used to treat lung cancer or certain types of blood, bone marrow, or metastatic cancer. Mustargen belongs to a group of drugs called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

This medication is available as an injection and is given slowly into a vein (IV) or directly into a body cavity by a healthcare professional.

Common side effects of Mustargen may include nausea, weakness, and vomiting. This medications can also cause dizziness. Do not drive or operate heavy machinery until you know how Mustargen affects you.

Mustargen is used in the treatment of the following:

• Hodgkin's lymphoma (Hodgkin's disease)
• certain types of non-Hodgkin's lymphoma (type of cancer that begins in a type of white blood cell that normally fights infection)
• mycosis fungoides (a type of immune system cancer that first appears as skin rashes)
• chronic lymphocytic or chronic myelocytic leukemia (cancer of the white blood cells)
• lung cancer
• polycythemia vera (disease in which too many red blood cells are made in the bone marrow)
• malignant effusions (fluid collects in the lungs or around the heart)

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Recordati Rare Diseases, Inc.

Serious side effects have been reported with Mustargen. See the “Mustargen Precautions” section.

Common side effects of Mustargen include the following:

• nausea
• weakness
• vomiting

This is not a complete list of Mustargen side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

No drug interactions have been studied by the manufacturer. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Serious side effects have been reported with Mustargen.

The following serious side effects have been reported with Mustargen:

• thrombosis (blood clot). Tell your doctor right away if you have any of the following symptoms: warmth and tenderness over the vein, pain or swelling in the part of the body affected, skin redness, chest pain, shortness of breath.
• lowered blood count. This may cause certain symptoms and may increase the risk that you will develop a serious or life-threatening infection or bleeding.  If you experience any of the following symptoms, call your doctor immediately: fever, chills, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black tarry stools; bloody vomit; or vomiting blood or brown material that resembles coffee grounds.
• low platelet count (thrombocytopenia). Tell your doctor right away if you have any unusual bleeding, such as nosebleeds, or bruising under your skin.
• hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following: chest pain, swelling of the face, eyes, lips, tongue, arms, or legs, difficulty breathing or swallowing, rash.
• hemolytic anemia. This occurs when Mustargen triggers the body's immune system to attack its own red blood cells causing the red blood cells to break down. Tell your doctor right away if you have any of the following symptoms: dark urine, fatigue, pale skin color, rapid heart rate, shortness of breath, yellow skin.
• severe skin reactions. Severe skin reactions may happen after treatment with Mustargen injection, especially if you have lymphoma in or under your skin. If your skin reactions are severe, they may lead to serious illness or death. Tell your doctor right away if you have any of the following skin reactions: rash, peeling and loss of skin, sores, blisters.
• interference with normal menstrual cycle (period) in women, may stop sperm production in men, and may cause infertility (difficulty becoming pregnant). You should not assume that you or your partner cannot become pregnant. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant or breastfeed while you are receiving Mustargen since it may harm the fetus.

Mustargen can cause dizziness. Do not drive or operate heavy machinery until you know how Mustargen affects you.

Do not use Mustargen if you:

• have known infectious diseases
• are allergic to Mustargen or any of its ingredients

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Mustargen, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking Mustargen, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Mustargen or to any of its ingredients
• have an infection
• have previously received or will be receiving radiation (x-ray) therapy or other chemotherapy
• are pregnant, plan to become pregnant, or are breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories -A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Mustargen falls into category D. It has been shown that use of Mustargen in pregnant women caused some babies to be born with problems. However, in some serious situations, the benefit of using this medication may be greater than the risk of harm to the baby. 

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Mustargen crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Mustargen.

Mustargen is available in an injectable form to be given directly into a vein (IV) or directly into a body cavity by a healthcare professional.

If you miss a dose, be sure to make a follow up appointment.

The dosage of Mustargen (mechlorethamine) injection is based on your body weight and response to treatment.  Your healthcare provider will determine the appropriate dose to give to you.

If Mustargen is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Mustargen should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents.
This drug is HIGHLY TOXIC and both powder and solution must be handled and administered with care. Inhalation of dust or vapors and contact with skin or mucous membranes, especially those of the eyes, must be avoided. Avoid exposure during pregnancy. Due to the toxic properties of Mustargen (e.g., corrosivity, carcinogenicity, mutagenicity, teratogenicity), special handling procedures should be reviewed prior to handling and followed diligently. Extravasation of the drug into subcutaneous tissues results in a painful inflammation. The area usually becomes indurated and sloughing may occur. If leakage of drug is obvious, prompt infiltration of the area with sterile isotonic sodium thiosulfate (1/6 molar) and application of an ice compress for 6 to 12 hours may minimize the local reaction. For a 1/6 molar solution of sodium thiosulfate, use 4.14 g of sodium thiosulfate per 100 mL of Sterile Water for Injection or 2.64 g of anhydrous sodium thiosulfate per 100 mL or dilute 4 mL of Sodium Thiosulfate Injection (10%) with 6 mL of Sterile Water for Injection.