Valchlor

What is Valchlor?

Valchlor (Mechlorethamine hydrochloride) is an alkylating drug used for the topical treatment of people with Stage 1A and 1B mycosis fungoides-type cutaneous T-cell lymphoma.

Mechlorethamine

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What are the uses of this medicine?

• Valchlor (Mechlorethamine hydrochloride) is a prescription medicine used on the skin (topical) to treat people with Stage 1A and 1B mycosis fungoides-type cutaneous T-cell lymphoma who have received previous skin treatment.

How does this medicine work?

• A gel formulation composed of the hydrochloride salt form of mechlorethamine, which is a nitrogen mustard alkylating agent and an analog of sulfur mustard, with antineoplastic and immunosuppressive activities.
• Upon topical application, mechlorethamine is metabolized to an unstable, highly reactive ethyleniminium intermediate that binds to and alkylates DNA, with a high affinity to the N7 nitrogen of guanine residues.
• This results in DNA base pair mismatching, DNA interstrand crosslinking, the inhibition of DNA repair and synthesis, cell-cycle arrest, and apoptosis.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• known severe hypersensitivity to mechlorethamine.

What drug interactions can this medicine cause?

• No drug interaction studies have been performed with Valchlor.

Is this medicine FDA approved?

• Mechlorethamine was approved for use in the United States in 1949.

How should this medicine be used?

Recommended dosage:

• Apply a thin film of Valchlor gel once daily to affected areas of the skin.

Administration:

• Caregivers must wear disposable nitrile gloves when applying Valchlor.
• Wash your hands with soap and water after touching or applying Valchlor.
• Safely throw away used disposable nitrile gloves in household trash.
• Apply Valchlor right away or within 30 minutes after you take it out of the refrigerator.
• Return Valchlor to the refrigerator right after each use.
• Apply a thin layer of Valchlor 1 time each day (or as instructed by your healthcare providers) to completely dry affected areas of the skin at least 4 hours before or 30 minutes after showering or washing.
• Let the treated areas dry for 5 to 10 minutes after applying Valchlor before covering with clothing.
• Moisturizers may be applied to the treated areas 2 hours before or 2 hours after applying Valchlor.
• You should not use air or water-tight bandages on areas of the skin treated with Valchlor.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Gel: 0.016% w/w of mechlorethamine (equivalent to 0.02% mechlorethamine HCl) in 60g tubes

This medicine is available in fallowing brand namesː

• Valchlor

What side effects can this medication cause?

The most common side effects of this medicine include:

• redness
• swelling
• itching
• skin ulcers or blisters
• skin infection
• darkening of areas of your skin

Valchlor may cause fertility problems in females and males.

Valchlor can cause serious side effects, including:

• dermatitis
• Increased risk of certain types of skin cancers
• Risk of Secondary Exposure to Valchlor

What special precautions should I follow?

• Valchlor exposure to mucous membranes, especially of the eyes, can cause mucosal injury which may be severe. Eye injury may lead to blindness. Immediately irrigate for at least 15 minutes followed by immediate medical consultation.
• Avoid direct skin contact with Valchlor in individuals other than the patient.
• The most common adverse reaction was dermatitis, which occurred in 56% of the patients. Monitor patients for redness, swelling, inflammation, itchiness, blisters, ulceration, and secondary skin infections. Stop treatment or reduce dose frequency.
• Patients developed a non-melanoma skin cancer. Monitor patients during and after treatment.
• Valchlor may cause fetal harm. Advise women to avoid becoming pregnant while using Valchlor.
• Valchlor is an alcohol-based gel. Avoid fire, flame, and smoking until the gel has dried.

What to do in case of emergency/overdose?

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Based on case reports in humans, findings in animal reproduction studies, its mechanism of action, and genotoxicity findings, mechlorethamine may cause fetal harm.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

• Active ingredient: mechlorethamine
• Inactive ingredients: diethylene glycol monoethyl ether, propylene glycol, isopropyl alcohol, glycerin, lactic acid, hydroxypropylcellulose, sodium chloride, menthol, edetate disodium, butylated hydroxytoluene

Who manufactures and distributes this medicine?

Manufactured for:

• Helsinn Therapeutics (U.S.), Inc., Iselin, NJ

What should I know about storage and disposal of this medication?

• Store Valchlor in the refrigerator between 36°F to 46°F (2°C to 8°C).
• Keep Valchlor away from food in the refrigerator.
• With clean hands, place Valchlor back in the box it came in and return it to the refrigerator right after each use.
• Talk with your pharmacist before you use Valchlor that has been out of the refrigerator for more than one hour a day.
• Safely throw away Valchlor that is not used after 90 days.
• Unused Valchlor, empty tubes, and used disposable nitrile gloves should be safely thrown away in household trash.

• Dailymed label info on Valchlor
• FDA Valchlor

Valchlor Resources
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