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Topical Nitrogen Mustard (mechlorethamine)

Topical Chemotherapy
Nitrogen Mustard (mechlorethamine)
(me-klor-ETH-a-meen)
Brand name: Mustargen
Other names: chlormethine, nitrogen mustard

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 and can be formulated in water or ointment base.  Individual skin lesions may be treated, but typically, NM is applied to involved and uninvolved areas of the skin.

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.  Nylon paintbrushes may be used to apply the water based NM or gloves may be used to apply the ointment based NM.  Care should be taken to avoid transferring the compound to other individuals by direct contact with the skin.

The most frequent complication of topical NM therapy is the development of an irritant reaction (itching or stinging) which usually subsides with a dose adjustment. Some 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 systemic agents in some cases of advanced stage disease.

Mechlorethamine FAQs

Additional Information
More information on mechlorethamine is available from: The National Institutes of Health (This is an external link that will open in a new window.)

For information about nitrogen mustard in gel form, please visit Crossing Care. (This is an external link that will open in a new window.)

Ovation is offering a patient access program to assist patients and physicians who seek reimbursement for Mustargen. The Ovation Reimbursement Support Program provides assistance for patients with insurance coverage issues and a Patient Assistance Program for patients with financial need. Patients and physicians can contact The Ovation Reimbursement Support Program by calling 1-866-209-7604. (This is an external link that will open in a new window.)

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...

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