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Topical Chemotherapy: Mechlorethamine (Mustargen®)

Topical Chemotherapy
Nitrogen Mustard (mechlorethamine)
Brand name: Mustargen®

Mechlorethamine, also known as nitrogen mustard (NM), is an anti-cancer drug that inhibits DNA replication.  Originally developed as an intravenous cancer chemotherapy, its topical application to the skin has been shown to be an effective treatment of early stage (Stage I-A, I-B, and II-A) CTCL.

Topical NM is compounded (mixed) by specialty pharmacists. Originally it was formulated in water but is mostly available today in a compounded ointment base.  Individual skin lesions are typically treated; however, NM can be applied to involved and uninvolved areas of the skin when appropriate.

NM should be applied to a dry skin surface area at a time when it can remain on the skin for at least four hours.  It need not be washed off after application. Hands should be washed after application to avoid trapping in finger web spaces and transferring the compound to other individuals.

The most frequent complication of topical NM therapy is the development of an irritant reaction (itching or stinging) which usually subsides with a dose or application frequency adjustment. Approximately ten percent of individuals may develop an allergic reaction which usually occurs within three to six weeks after initiation of treatment. Symptoms include reddening, burning, stinging, or itching. In severe cases, the skin may develop blisters, like a poison ivy reaction.  Topical nitrogen mustard may be combined with topical steroids and/or systemic agents in some cases of advanced stage disease.

Additional Information
More information on mechlorethamine is available from: The National Institutes of Health.

For information about nitrogen mustard in gel form, please visit Converse Care.

Some compounding pharmacies will bill patients ’ insurance companies for topical Mustargen and ship the product to patients who reside outside of their geographic area. read more...