Valchlor

Name: Valchlor

Uses of Valchlor

Valchlor is a prescription medication available as a topical (applied to the skin) form.

Valchlor is used in the treatment of Stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma (a type of immune system cancer that begins with skin rashes). Valchlor is given to patients who have received prior skin-directed therapy.

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

Valchlor Overdose

If you use too much Valchlor, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Valchlor FDA Warning

  

 

  

How should I use mechlorethamine topical?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Mechlorethamine topical is usually applied once daily.

Store this medicine in its original container (box) in the refrigerator. Do not freeze. Avoid allowing this medicine to come into contact with food in the refrigerator.

Apply the medicine within 30 minutes after removing it from the refrigerator. After use, put the medicine back into the refrigerator right away.

Do not use within the first 30 minutes after taking a shower or bath. Make sure the skin is completely dry before applying the medicine. Do not bathe or shower for at least 4 hours after applying mechlorethamine topical.

Apply a thin layer of the medicine to the affected skin areas. Allow the gel to dry for 5 to 10 minutes before covering the treated skin with clothing.

Do not cover the treated skin area with a bandage.

You may apply skin lotion, cream, or oil to treated skin 2 hours before or 2 hours after applying mechlorethamine topical.

Wash your hands after applying or handling this medicine. If you are a caregiver, wear disposable gloves to apply the medicine to the patient and wash your hands after removing the gloves and throwing them away.

Mechlorethamine topical gel is flammable. Do not use near high heat or open flame. Do not smoke until the gel has completely dried on your skin.

Throw away any unused mechlorethamine topical gel after 90 days. Throw away unused gel, empty tubes, and used disposable gloves in a trash container out of the reach of children and pets.

Valchlor Dosage and Administration

Administration

Topical Administration

Apply to skin as commercially available 0.016% mechlorethamine gel.1

Has been applied to skin as aqueous solution or ointment-based preparation compounded extemporaneously using mechlorethamine hydrochloride for injection.3 4 7 8 11

For topical dermatologic use only.1 Do not use near or in the eyes, nose, or mouth.1 (See Mucosal or Eye Injury under Cautions.)

Wash hands thoroughly with soap and water after handling or applying the drug.1 (See Warnings/Precautions under Cautions.)

Application by Caregiver

Manufacturer states caregiver must wear disposable nitrile gloves during application and wash hands thoroughly with soap and water after removing the gloves.1

In case of accidental skin exposure, immediately wash exposed areas thoroughly with soap and water for ≥15 minutes and remove contaminated clothing.1

In case of accidental exposure to eyes, mouth, or nose, immediately irrigate exposed area for ≥15 minutes with copious amounts of water.1

Gel

Apply gel immediately (or within 30 minutes) after removal from refrigerator; return gel to refrigerator immediately after each use.1

Apply gel to completely dry skin ≥4 hours before or ≥30 minutes after showering or washing affected areas.1 After application, allow treated areas to dry for 5–10 minutes before covering with clothing.1

May apply emollients (moisturizers) to treated areas 2 hours before or 2 hours after application of the gel.1

Do not use occlusive dressings on treated areas.1

Avoid fire, flame, and smoking until gel has dried.1

Extemporaneously Compounded Ointment

Usually prepared by dissolving mechlorethamine hydrochloride in dehydrated alcohol, filtering the solution to remove insoluble sodium chloride present in the commercial preparation (although filtration may not be necessary), and mixing the drug-alcohol solution into petrolatum or another anhydrous ointment base (e.g., hydrophilic petrolatum).11 12 15 Usual mechlorethamine hydrochloride concentration is 0.01 or 0.02%.3 4 7 8 11 12 14 15 Consult specialized references for detailed information on preparation of topical ointments.

Extemporaneously Compounded Solution

Usually prepared by dissolving 10 mg of mechlorethamine hydrochloride in 50–100 mL of water.4 11 16 17 18 19 20 Consult specialized references for detailed information on preparation of topical solutions.

Because of limited stability, prepare solution immediately before use.4 11

Dosage

Available as mechlorethamine hydrochloride; dosage of gel expressed in terms of mechlorethamine.1

Adults

Mycosis Fungoides-type CTCL Topical

Apply thin film of mechlorethamine 0.016% gel to affected areas once daily.1

Interrupt treatment if any skin ulceration or blistering, or moderately severe or severe dermatitis (i.e., marked erythema with edema), occurs.1

Upon improvement, may resume with reduced frequency of once every 3 days.1 If reintroduction tolerated for ≥1 week, may increase application frequency to every other day for ≥1 week and then to once daily if tolerated.1

Concentration of mechlorethamine hydrochloride in topical solutions and ointments, frequency of application, and duration of treatment have been based on dermatologic response and tolerance.4 11 16 Usual ointment concentration is 0.01 or 0.02%;3 4 7 8 11 12 14 15 may use lower concentrations initially in patients with dermatitis or history of hypersensitivity reactions to the topically applied drug, or use higher concentrations in patients with extensive or resistant lesions.4 11 12 14 15

Topical applications of mechlorethamine preparations generally are repeated once daily until the lesions disappear.4 11 Optimal duration of therapy following clinical remission not fully established.4 8 11

Special Populations

No special population dosage recommendations at this time.1

Interactions for Valchlor

Drug interaction studies not performed to date.1 Systemic drug interactions unlikely.1

Valchlor Pharmacokinetics

Absorption

Bioavailability

Mechlorethamine was undetectable in plasma following topical administration of mechlorethamine 0.016% gel once daily for one month.1

Mechlorethamine and half-mustard were undetectable in plasma after 2, 4, or 6 months of treatment with mechlorethamine 0.032% gel once daily.1 7

Distribution

Extent

Not known whether distributed into milk.1

Precautions While Using Valchlor

It is very important that your doctor check your progress at regular visits for any unwanted effects that may be caused by this medicine.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Do not get this medicine in your eyes. If eye contact occurs, you may have pain, burning, swelling, redness, sensitivity to light, or blurred vision. The medicine can cause permanent eye injury. If you get this medicine in your eye, rinse the eye right away for at least 15 minutes with water or an eye wash solution and call your doctor.

Avoid getting this medicine in your nose or mouth. It may cause pain, redness, or ulcers. If this occurs, rinse your nose or mouth right away for at least 15 minutes with water and call your doctor.

This medicine may cause unwanted skin reactions, including non-melanoma skin cancer. Contact your doctor right away if you have redness, swelling, itching, ulcers, or blisters on the skin.

If OVERDOSE is suspected

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Important information

Avoid getting Valchlor in your eyes. Valchlor gel can cause blindness or permanent injury to your eyes. If this medication gets in your eyes, rinse them for at least 15 minutes with a large amount of water, normal saline, or an eye wash solution, and then seek emergency medical attention.

Avoid getting this medication in your mouth or nose. If this does happen, rinse for at least 15 minutes with a large amount of water and seek emergency medical attention. Valchlor can cause pain, redness, or ulcers if it gets in your mouth or nose.

Always get emergency medical help if this medication accidentally gets in your eyes, nose, or mouth.

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