Mechlorethamine (Chlormethine, Mustargen, Mustine, nitrogen mustard)
This page tells you about the chemotherapy drug mechlorethamine and its possible side effects. There is information about
- What mechlorethamine is
- How mechlorethamine works
- How you have mechlorethamine
- Tests during treatment
- About side effects
- Common side effects
Mechlorethamine is a chemotherapy drug. It is pronounced mee-claw-eth-a-meen. It used to be called nitrogen mustard, mustine or chlormethine. Its brand name is Mustargen.
It is a treatment for
- Hodgkin lymphoma
- Non Hodgkin lymphoma
- Lung cancer
- Chronic lymphocytic leukaemia
- Chronic myeloid leukaemia
It is not often used in the UK but may be used as part of clinical trials.
Mechlorethamine is a clear liquid. You have it into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
You usually have chemotherapy as a course of several cycles of treatment in which you have the drug and then have a break for some time to allow your body to recover.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with mechlorethamine. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having mechlorethamine with other medicines.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick occurs in up to half the people having mechlorethamine. It is most likely to happen within 3 hours of starting treatment and may last for up to 24 hours. It can usually be controlled with anti sickness medicines. Let your doctor or nurse know if you still feel sick
- Loss of appetite
- Hair Loss is most likely to start about 3 to 4 weeks after your treatment starts. Your hair will grow back when your treatment ends
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Women may stop having periods (amenorrhoea) but this may be temporary
- Inflammation around the drip site – you may notice pain or signs of redness, swelling or leaking at your drip site. Tell your doctor or chemotherapy nurse straight away
Between 1 and 10 in every 100 people have one or more of these.
- Mechlorethamine can cause pain and burning where you have your injection – hot or cold packs may help
- Diarrhoea – drink plenty of fluids. Tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
- A skin rash that may be itchy
- Painful, swollen joints
- Difficulty breathing or swallowing
- Numbness or tingling in the fingers and toes – you may have trouble with fiddly tasks such as doing up buttons. This can start a few days or weeks after treatment. It usually goes away within a few months of the treatment finishing
Fewer than 1 in 100 people have these.
- Ringing in the ears (tinnitus) or difficulty hearing
- Very rarely, another cancer can develop years after finishing the treatment
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
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