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Mechlorethamine – Uses, Dosage, Side Effects, Interaction

Mechlorethamine - Uses, Dosage, Side Effects, Interaction

Mechanism of Action

Alkylating agents work by three different mechanisms: 1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA, 2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations. Mechlorethamine is cell cycle phase-nonspecific. Mechlorethamine, as an alkylating agent, interferes with DNA replication and transcription of RNA, and ultimately results in the disruption of nucleic acid function.

or

The alkylating agent, nitrogen mustard (HN2), is thought to cause apoptosis through the production of free oxygen radicals. To explore the mechanism of HN2-induced apoptosis, we utilized ebselen, a selenoorganic compound with potent antioxidant activity. We examined whether ebselen would inhibit apoptosis in BALB/c mouse spleen lymphocytes and human MOLT-4 leukemia cells treated with HN2 (2.5 microM) in vitro. Non-toxic concentrations (<50 micron m) of ebselen were found to prevent HN2-induced apoptosis of murine lymphocytes in a dose-dependent manner, as measured by cell viability, hypodiploid DNA formation, and phosphatidylserine externalization. However, ebselen was ineffective at preventing spontaneous apoptosis in these cells, pointing to the selectivity of its action. Furthermore, pretreatment with ebselen at 1-10 microM for 72 hr protected MOLT-4 cells from HN2-induced apoptosis and maintained cell viability and proliferation as monitored by the above-mentioned parameters. This was accompanied by the preservation of mitochondrial transmembrane potential and elevated glutathione levels and by a blockage of caspase-3 and -9 activation. In vivo, ebselen also had a marked protective effect against spleen weight loss associated with lymphocyte apoptosis in mice treated by HN2. Therefore, ebselen provides efficient protection against HN2-induced cell death in normal and tumoral lymphocytes and might prove useful as an antidote against alkylating agents.

Mechlorethamine also known as mustine, nitrogen mustard, and HN2, is the prototype anticancer chemotherapeutic drug. Successful clinical use of mechlorethamine gave birth to the field of anticancer chemotherapy. The drug is an analog of mustard gas and was derived from toxic gas warfare research. Mechlorethamine is a nitrogen mustard alkylating agent. Alkylating agents work by three different mechanisms all of which achieve the same end result – disruption of DNA function and cell death.

Indications

  • For the palliative treatment of Hodgkin’s disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungicides, and bronchogenic carcinoma. Also for the palliative treatment of metastatic carcinoma resulting in effusion.
  • Ledaga is indicated for the topical treatment of mycosis fungoides-type cutaneous T-cell lymphoma (MF-type CTCL) in adult patients.
  • Mechlorethamine is a nitrogen mustard and antineoplastic agent that has been in clinical use for more than 60 years, given systemically in combination with other antineoplastic agents to treat Hodgkin disease, chronic leukemias, lung cancer, and polycythemia vera. Currently, however, it is used largely as a topical gel for the therapy of cutaneous T-cell lymphomas and mycosis fungoides.
  • Mechlorethamine is an antineoplastic agent used to treat Hodgkin’s disease, lymphosarcoma, and chronic myelocytic or lymphocytic leukemia.
  • For the palliative treatment of Hodgkin’s disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungoides, and bronchogenic carcinoma. Also for the palliative treatment of metastatic carcinoma resulting in effusion.
  • Carcinoma, Bronchogenic
  • Chronic Lymphocytic Leukemia
  • Hodgkins Disease (HD)
  • Lymphoma, Diffuse
  • Mycosis Fungoides (MF)
  • Polycythemia Vera (PV)
  • Stage I Mycosis Fungoides
  • Malignant effusion

Contraindications

  • a bad infection
  • accumulation of a amyloid protein in organs and tissues
  • decreased function of bone marrow
  • anemia
  • increased risk of bleeding due to clotting disorder
  • decreased blood platelets
  • low levels of white blood cells
  • low levels of granulocytes, a type of white blood cell
  • high amount of uric acid in the blood
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • spread of malignant cancer to the bone marrow

Dosage

Strengths: 10 mg

Malignant Disease

  • IV: 0.4 mg/kg either as a single dose or in divided doses of 0.1 to 0.2 mg/kg per day
  • Intracavitary (intrapleurally, intraperitoneal): 0.4 mg/kg
  • Intrapericardial: 0.2 mg/kg
  • The presence of edema or ascites must be considered so dosage will be based on actual weight unaugmented by these conditions.
  • The dosage varies with the clinical situation, the therapeutic response and the magnitude of hematologic depression.
  • Intravenously: Palliative treatment of Hodgkin’s disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungoides, and bronchogenic carcinoma.
  • Intracavitary and Intrapericardial: Palliative treatment of metastatic carcinoma resulting in pleural, peritoneal, and/or pericardial effusion.
  • Should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents.
  • This drug is highly toxic and both powder and solution must be handled and administered with care. Inhalation of dust or vapors and contact with skin or mucous membranes, especially those of the eyes, must be avoided. Avoid exposure during pregnancy. Due to the toxic properties of this drug (e.g., corrosivity, carcinogenicity, mutagenicity, teratogenicity), special handling procedures should be reviewed prior to handling and followed diligently.
  • Extravasation of the drug into subcutaneous tissues results in a painful inflammation. The area usually becomes indurated and sloughing may occur. If leakage of drug is obvious, prompt infiltration of the area with sterile isotonic sodium thiosulfate (1/6 molar) and application of an ice compress for 6 to 12 hours may minimize the local reaction. For a 1/6 molar solution of sodium thiosulfate, use 4.14 g of sodium thiosulfate per 100 mL of Sterile Water for Injection or 2.64 g of anhydrous sodium thiosulfate per 100 mL or dilute 4 mL of Sodium Thiosulfate Injection (10%) with 6 mL of Sterile Water for Injection.

Administration advice:

  • Since this drug is highly toxic, appropriate precautions including the use of appropriate safety equipment are recommended for the preparation of this drug for parenteral administration.
  • Not for oral administration
  • Reconstitution/preparation techniques: The manufacturer’s product information should be consulted.
  • Repeated examinations of blood are mandatory as a guide to subsequent therapy.
  • The margin of safety in therapy is narrow and considerable care must be exercised in the matter of dosage.
  • Solutions of the drug should be prepared immediately before use.
  • Protect from light and humidity.

Side Effects

The Most Common

  • nausea
  • vomiting
  • loss of appetite
  • diarrhea
  • unusual tiredness or weakness
  • dizziness
  • painful, swollen joints
  • ringing in ears and difficulty hearing
  • fever, chills, sore throat, ongoing cough and congestion, or other signs of an infection
  • unusual bleeding or bruising
  • bloody or black, tarry stools
  • bloody vomit
  • vomited material that looks like coffee grounds
  • bleeding gums
  • small, round, red or purple colored spots on the skin
  • hives
  • rash
  • itching
  • difficulty breathing or swallowing
  • numbness or tingling in your hands or feet
  • irregular heartbeat

More common

  • Black, tarry stools
  • blood in urine or stools
  • cough or hoarseness
  • fever or chills
  • lower back or side pain
  • pain or redness at place of injection
  • painful or difficult urination
  • pinpoint red spots on skin
  • unusual bleeding or bruising

Rare

  • Shortness of breath, itching, or wheezing
  • Missing menstrual periods
  • painful rash
  • Dizziness
  • joint pain
  • loss of hearing
  • ringing in ears
  • swelling of feet or lower legs
  • Numbness, tingling, or burning of fingers, toes, or face
  • sores in the mouth and on lips
  • yellow eyes or skin
  • Nausea and vomiting (usually lasts only 8 to 24 hours)
  • Confusion
  • diarrhea
  • drowsiness
  • headache
  • loss of appetite
  • metallic taste
  • weakness

Drug Interactions

Pregnancy and Lactation

FDA Pregnancy Category D

Pregnancy

Mechlorethamine can cause fetal harm when administered to a pregnant woman. There are case reports of children born with malformations in pregnant women systemically administered mechlorethamine. Mechlorethamine was teratogenic in animals after a single subcutaneous administration. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus.

Lactation

It is not known if mechlorethamine is excreted in human milk. Due to the potential for topical or systemic exposure to VALCHLOR through exposure to the mother’s skin, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Safety and effectiveness in pediatric patients have not been established.

Why is this medication prescribed?

Mechlorethamine is used to treat Hodgkin’s lymphoma (Hodgkin’s disease) and certain types of non-Hodgkin‘s lymphoma (types of cancer that begin in a type of white blood cells that normally fights infection); mycosis fungoides (a type of cancer of the immune system that first appear as skin rashes); certain types of leukemia (cancer of the white blood cells), including chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML); and lung cancer. Mechlorethamine is also used to treat polycythemia vera (a disease in which too many red blood cells are made in the bone marrow). It is also used to treat malignant effusions (a condition when fluid collects in the lungs or around the heart) that are caused by cancerous tumors. Mechlorethamine is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

How should this medicine be used?

Mechlorethamine comes as powder to be mixed with liquid to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. It may also be injected intraperitoneally (into the abdominal cavity), intrapleurally (into the chest cavity), or intrapericardially (into the lining of the heart). The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer or condition you have. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

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

What special precautions should I follow?

Before receiving mechlorethamine,

  • tell your doctor and pharmacist if you are allergic to mechlorethamine, any other medications, or any of the ingredients in mechlorethamine injection. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
  • tell your doctor if you have an infection. Your doctor may not want you to receive mechlorethamine.
  • tell your doctor if you have previously received or will be receiving radiation (x-ray) therapy or other chemotherapy and if you have or have ever had any medical conditions..
  • you should know that mechlorethamine may interfere with the normal menstrual cycle (period) in women, may stop sperm production in men, and may cause infertility (difficulty becoming pregnant). However, you should not assume that you or your partner cannot become pregnant. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not become pregnant or breast-feed while you are receiving mechlorethamine injection. Mechlorethamine may harm the fetus.

Frequently Asked Questions

Mechanism of ActionAlkylating agents work by three different mechanisms: 1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA, 2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations. Mechlorethamine is cell cycle phase-nonspecific. Mechlorethamine, as an alkylating agent, interferes with DNA replication and transcription of RNA, and ultimately results in the disruption of nucleic acid function.orThe alkylating agent, nitrogen mustard (HN2), is thought to cause apoptosis through the production of free oxygen radicals. To explore the mechanism of HN2-induced apoptosis, we utilized ebselen, a selenoorganic compound with potent antioxidant activity. We examined whether ebselen would inhibit apoptosis in BALB/c mouse spleen lymphocytes and human MOLT-4 leukemia cells treated with HN2 (2.5 microM) in vitro. Non-toxic concentrations (<50 micron m) of ebselen were found to prevent HN2-induced apoptosis of murine lymphocytes in a dose-dependent manner, as measured by cell viability, hypodiploid DNA formation, and phosphatidylserine externalization. However, ebselen was ineffective at preventing spontaneous apoptosis in these cells, pointing to the selectivity of its action. Furthermore, pretreatment with ebselen at 1-10 microM for 72 hr protected MOLT-4 cells from HN2-induced apoptosis and maintained cell viability and proliferation as monitored by the above-mentioned parameters. This was accompanied by the preservation of mitochondrial transmembrane potential and elevated glutathione levels and by a blockage of caspase-3 and -9 activation. In vivo, ebselen also had a marked protective effect against spleen weight loss associated with lymphocyte apoptosis in mice treated by HN2. Therefore, ebselen provides efficient protection against HN2-induced cell death in normal and tumoral lymphocytes and might prove useful as an antidote against alkylating agents.Mechlorethamine also known as mustine, nitrogen mustard, and HN2, is the prototype anticancer chemotherapeutic drug. Successful clinical use of mechlorethamine gave birth to the field of anticancer chemotherapy. The drug is an analog of mustard gas and was derived from toxic gas warfare research. Mechlorethamine is a nitrogen mustard alkylating agent. Alkylating agents work by three different mechanisms all of which achieve the same end result - disruption of DNA function and cell death.IndicationsFor the palliative treatment of Hodgkin's disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungicides, and bronchogenic carcinoma. Also for the palliative treatment of metastatic carcinoma resulting in effusion. Ledaga is indicated for the topical treatment of mycosis fungoides-type cutaneous T-cell lymphoma (MF-type CTCL) in adult patients. Mechlorethamine is a nitrogen mustard and antineoplastic agent that has been in clinical use for more than 60 years, given systemically in combination with other antineoplastic agents to treat Hodgkin disease, chronic leukemias, lung cancer, and polycythemia vera. Currently, however, it is used largely as a topical gel for the therapy of cutaneous T-cell lymphomas and mycosis fungoides. Mechlorethamine is an antineoplastic agent used to treat Hodgkin's disease, lymphosarcoma, and chronic myelocytic or lymphocytic leukemia. For the palliative treatment of Hodgkin's disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungoides, and bronchogenic carcinoma. Also for the palliative treatment of metastatic carcinoma resulting in effusion. Carcinoma, Bronchogenic Chronic Lymphocytic Leukemia Hodgkins Disease (HD) Lymphoma, Diffuse Mycosis Fungoides (MF) Polycythemia Vera (PV) Stage I Mycosis Fungoides Malignant effusionContraindicationsa bad infection accumulation of a amyloid protein in organs and tissues decreased function of bone marrow anemia increased risk of bleeding due to clotting disorder decreased blood platelets low levels of white blood cells low levels of granulocytes, a type of white blood cell high amount of uric acid in the blood pregnancy a patient who is producing milk and breastfeeding spread of malignant cancer to the bone marrowDosage Strengths: 10 mg Malignant DiseaseIV: 0.4 mg/kg either as a single dose or in divided doses of 0.1 to 0.2 mg/kg per day Intracavitary (intrapleurally, intraperitoneal): 0.4 mg/kg Intrapericardial: 0.2 mg/kg The presence of edema or ascites must be considered so dosage will be based on actual weight unaugmented by these conditions. The dosage varies with the clinical situation, the therapeutic response and the magnitude of hematologic depression. Intravenously: Palliative treatment of Hodgkin's disease (Stages III and IV), lymphosarcoma, chronic myelocytic or chronic lymphocytic leukemia, polycythemia vera, mycosis fungoides, and bronchogenic carcinoma. Intracavitary and Intrapericardial: Palliative treatment of metastatic carcinoma resulting in pleural, peritoneal, and/or pericardial effusion. Should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents. This drug is highly toxic and both powder and solution must be handled and administered with care. Inhalation of dust or vapors and contact with skin or mucous membranes, especially those of the eyes, must be avoided. Avoid exposure during pregnancy. Due to the toxic properties of this drug (e.g., corrosivity, carcinogenicity, mutagenicity, teratogenicity), special handling procedures should be reviewed prior to handling and followed diligently. Extravasation of the drug into subcutaneous tissues results in a painful inflammation. The area usually becomes indurated and sloughing may occur. If leakage of drug is obvious, prompt infiltration of the area with sterile isotonic sodium thiosulfate (1/6 molar) and application of an ice compress for 6 to 12 hours may minimize the local reaction. For a 1/6 molar solution of sodium thiosulfate, use 4.14 g of sodium thiosulfate per 100 mL of Sterile Water for Injection or 2.64 g of anhydrous sodium thiosulfate per 100 mL or dilute 4 mL of Sodium Thiosulfate Injection (10%) with 6 mL of Sterile Water for Injection.Administration advice:Since this drug is highly toxic, appropriate precautions including the use of appropriate safety equipment are recommended for the preparation of this drug for parenteral administration. Not for oral administration Reconstitution/preparation techniques: The manufacturer's product information should be consulted. Repeated examinations of blood are mandatory as a guide to subsequent therapy. The margin of safety in therapy is narrow and considerable care must be exercised in the matter of dosage. Solutions of the drug should be prepared immediately before use. Protect from light and humidity.Side Effects The Most Commonnausea vomiting loss of appetite diarrhea unusual tiredness or weakness dizziness painful, swollen joints ringing in ears and difficulty hearing fever, chills, sore throat, ongoing cough and congestion, or other signs of an infection unusual bleeding or bruising bloody or black, tarry stools bloody vomit vomited material that looks like coffee grounds bleeding gums small, round, red or purple colored spots on the skin hives rash itching difficulty breathing or swallowing numbness or tingling in your hands or feet irregular heartbeatMore commonBlack, tarry stools blood in urine or stools cough or hoarseness fever or chills lower back or side pain pain or redness at place of injection painful or difficult urination pinpoint red spots on skin unusual bleeding or bruisingRareShortness of breath, itching, or wheezing Missing menstrual periods painful rash Dizziness joint pain loss of hearing ringing in ears swelling of feet or lower legs Numbness, tingling, or burning of fingers, toes, or face sores in the mouth and on lips yellow eyes or skin Nausea and vomiting (usually lasts only 8 to 24 hours) Confusion diarrhea drowsiness headache loss of appetite metallic taste weaknessDrug InteractionsDRUG INTERACTIONAbatacept The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Abatacept.Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Mechlorethamine.Acebutolol Mechlorethamine may increase the bradycardic activities of Acebutolol.Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Mechlorethamine.Acetylcholine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Acetylcholine.Acetyldigitoxin Acetyldigitoxin may decrease the cardiotoxic activities of Mechlorethamine.Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Mechlorethamine.Aclidinium Mechlorethamine may increase the neuromuscular blocking activities of Aclidinium.Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Mechlorethamine.Adenovirus type The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Mechlorethamine.Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Mechlorethamine.Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Mechlorethamine.Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mechlorethamine.Allogeneic pro The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Mechlorethamine.Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Mechlorethamine.Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Mechlorethamine.Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Mechlorethamine.Amantadine The therapeutic efficacy of Amantadine can be decreased when used in combination with Mechlorethamine.Amifampridine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Amifampridine.Amitriptyline The therapeutic efficacy of Amitriptyline can be decreased when used in combination with Mechlorethamine.Amobarbital The therapeutic efficacy of Amobarbital can be decreased when used in combination with Mechlorethamine.Amoxapine The therapeutic efficacy of Amoxapine can be decreased when used in combination with Mechlorethamine.Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Mechlorethamine.Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Mechlorethamine.Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Mechlorethamine.Anastrozole The risk or severity of cardiotoxicity can be increased when Mechlorethamine is combined with Anastrozole.Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Mechlorethamine.Anifrolumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Anifrolumab.Anisotropine The therapeutic efficacy of Anisotropine methylbromide can be decreased when used in combination with Mechlorethamine.Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Mechlorethamine.Anthrax immu The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Mechlorethamine.Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Mechlorethamine.Antilymphocyte im The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Antilymphocyte immunoglobulin (horse).Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Mechlorethamine.Antithrombin III h The risk or severity of bleeding can be increased when Antithrombin III human is combined with Mechlorethamine.Antithymocyte imm The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Mechlorethamine.Apixaban The risk or severity of bleeding can be increased when Apixaban is combined with Mechlorethamine.Apremilast The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Apremilast.Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Mechlorethamine.Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Mechlorethamine.Aripiprazole The therapeutic efficacy of Aripiprazole can be decreased when used in combination with Mechlorethamine.Arsenic trioxide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Arsenic trioxide.Articaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Articaine.AstraZeneca The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Mechlorethamine.Atenolol Mechlorethamine may increase the bradycardic activities of Atenolol.Atracurium The therapeutic efficacy of Atracurium can be decreased when used in combination with Mechlorethamine.Atracurium besylate The therapeutic efficacy of Atracurium besylate can be decreased when used in combination with Mechlorethamine.Atropine The therapeutic efficacy of Atropine can be decreased when used in combination with Mechlorethamine.Azacitidine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Azacitidine.Azathioprine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Azathioprine.Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Mechlorethamine.Bacillus calmette The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Mechlorethamine.Bacillus antigen The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Mechlorethamine.Baricitinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Baricitinib.Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Mechlorethamine.BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Mechlorethamine.Beclomethasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Beclomethasone dipropionate.Belatacept The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Belatacept.Belimumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Belimumab.Belinostat The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Belinostat.Belladonna The therapeutic efficacy of Belladonna can be decreased when used in combination with Mechlorethamine.Belumosudil The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Belumosudil.Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Mechlorethamine.Bendamustine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bendamustine.Bendroflumeth The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Mechlorethamine.Benzatropine The therapeutic efficacy of Benzatropine can be decreased when used in combination with Mechlorethamine.Benzocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Benzocaine.Benzonatate Mechlorethamine may increase the neuromuscular blocking activities of Benzonatate.Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Mechlorethamine.Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Benzyl alcohol.Betamethasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Betamethasone.Betamethasone p The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Betamethasone phosphate.Betaxolol Mechlorethamine may increase the bradycardic activities of Betaxolol.Bethanechol The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bethanechol.Betrixaban The risk or severity of bleeding can be increased when Betrixaban is combined with Mechlorethamine.Bevacizumab The risk or severity of cardiotoxicity can be increased when Bevacizumab is combined with Mechlorethamine.Bexarotene The risk or severity of adverse effects can be increased when Bexarotene is combined with Mechlorethamine.Bimekizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bimekizumab.Biperiden The therapeutic efficacy of Biperiden can be decreased when used in combination with Mechlorethamine.Bisoprolol Mechlorethamine may increase the bradycardic activities of Bisoprolol.Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Mechlorethamine.Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Mechlorethamine.Blinatumomab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Blinatumomab.Bordetella pertuss The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Bortezomib The risk or severity of adverse effects can be increased when Bortezomib is combined with Mechlorethamine.Bosutinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bosutinib.Brentuximab vedotin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Brentuximab vedotin.Brodalumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Brodalumab.Brompheniramine The therapeutic efficacy of Brompheniramine can be decreased when used in combination with Mechlorethamine.Buclizine The therapeutic efficacy of Buclizine can be decreased when used in combination with Mechlorethamine.Budesonide The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Budesonide.Bupivacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Bupivacaine.Busulfan The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Busulfan.Butabarbital The therapeutic efficacy of Butabarbital can be decreased when used in combination with Mechlorethamine.Butacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Butacaine.Butalbital The therapeutic efficacy of Butalbital can be decreased when used in combination with Mechlorethamine.Butamben The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Butamben.Butobarbital The therapeutic efficacy of Butobarbital can be decreased when used in combination with Mechlorethamine.Butylscopolamine The therapeutic efficacy of Butylscopolamine can be decreased when used in combination with Mechlorethamine.Cabazitaxel The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Cabazitaxel.Canakinumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Canakinumab.Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Mechlorethamine.Capecitabine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Capecitabine.Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Mechlorethamine.Capsaicin The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Capsaicin.Carbamazepine The risk or severity of adverse effects can be increased when Carbamazepine is combined with Mechlorethamine.Carbamoylcholine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Carbamoylcholine.Carboplatin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Carboplatin.Carfilzomib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Carfilzomib.Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Mechlorethamine.Carvedilol Mechlorethamine may increase the bradycardic activities of Carvedilol.Celiprolol Mechlorethamine may increase the bradycardic activities of Celiprolol.Certolizumab pegol The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Certolizumab pegol.Cevimeline The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Cevimeline.Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mechlorethamine.Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Mechlorethamine.Chloroprocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Chloroprocaine.Chlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Mechlorethamine.Chlorpromazine The therapeutic efficacy of Chlorpromazine can be decreased when used in combination with Mechlorethamine.Chlorprothixene The therapeutic efficacy of Chlorprothixene can be decreased when used in combination with Mechlorethamine.Ciclesonide The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Ciclesonide.Cilostazol The risk or severity of bleeding can be increased when Cilostazol is combined with Mechlorethamine.Cinchocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Cinchocaine.Cisatracurium The therapeutic efficacy of Cisatracurium can be decreased when used in combination with Mechlorethamine.Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Mechlorethamine.Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Mechlorethamine.Clevidipine Mechlorethamine may increase the neuromuscular blocking activities of Clevidipine.Clidinium The therapeutic efficacy of Clidinium can be decreased when used in combination with Mechlorethamine.Clobetasol propionate The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Clobetasol propionate.Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Mechlorethamine.Clopidogrel The risk or severity of bleeding can be increased when Clopidogrel is combined with Mechlorethamine.Clostridium t The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Clozapine The risk or severity of neutropenia can be increased when Mechlorethamine is combined with Clozapine.Cocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Cocaine.Corticotropin The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Corticotropin.Corticotropin zinc The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Corticotropin zinc hydroxide.Cortisone acetate The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Cortisone acetate.Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Mechlorethamine.Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Mechlorethamine.Cyclophosphamide The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Mechlorethamine.Cyclosporine Mechlorethamine may increase the immunosuppressive activities of Cyclosporine.Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Mechlorethamine.Cycrimine The therapeutic efficacy of Cycrimine can be decreased when used in combination with Mechlorethamine.Cyproheptadine The therapeutic efficacy of Cyproheptadine can be decreased when used in combination with Mechlorethamine.Cytarabine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Cytarabine.Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Mechlorethamine.Dabigatran etexe The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Mechlorethamine.Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mechlorethamine.Dactinomycin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Dactinomycin.Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Mechlorethamine.Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Mechlorethamine.Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Mechlorethamine.Darifenacin The therapeutic efficacy of Darifenacin can be decreased when used in combination with Mechlorethamine.Dasatinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Dasatinib.Daunorubicin The risk or severity of adverse effects can be increased when Daunorubicin is combined with Mechlorethamine.Decitabine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Decitabine.Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Mechlorethamine.Deflazacort The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Deflazacort.Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Mechlorethamine.Desipramine The therapeutic efficacy of Desipramine can be decreased when used in combination with Mechlorethamine.Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Mechlorethamine.Deslanoside Deslanoside may decrease the cardiotoxic activities of Mechlorethamine.Desloratadine The therapeutic efficacy of Desloratadine can be decreased when used in combination with Mechlorethamine.Desoximetasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Desoximetasone.Deucravacitinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Deucravacitinib.Dexamethasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Dexamethasone.Dexamethasone ac The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Dexamethasone acetate.Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Mechlorethamine.Dextran The risk or severity of bleeding can be increased when Dextran is combined with Mechlorethamine.Dextromethorphan The therapeutic efficacy of Dextromethorphan can be decreased when used in combination with Mechlorethamine.Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Mechlorethamine.Dicyclomine The therapeutic efficacy of Dicyclomine can be decreased when used in combination with Mechlorethamine.Difluocortolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Difluocortolone.Digitoxin Digitoxin may decrease the cardiotoxic activities of Mechlorethamine.Digoxin Digoxin may decrease the cardiotoxic activities of Mechlorethamine.Dimethyl fumarate The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Dimethyl fumarate.Dimetindene The therapeutic efficacy of Dimetindene can be decreased when used in combination with Mechlorethamine.Dinutuximab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Dinutuximab.Diphemanil The therapeutic efficacy of Diphemanil can be decreased when used in combination with Mechlorethamine.Diphenhydramine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Diphenhydramine.Diphenidol The therapeutic efficacy of Diphenidol can be decreased when used in combination with Mechlorethamine.Dipyridamole The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Dipyridamole.Diroximel fumarate The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Diroximel fumarate.Disopyramide The therapeutic efficacy of Disopyramide can be decreased when used in combination with Mechlorethamine.Docetaxel The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Docetaxel.Dosulepin The therapeutic efficacy of Dosulepin can be decreased when used in combination with Mechlorethamine.Doxacurium Mechlorethamine may increase the neuromuscular blocking activities of Doxacurium.Doxepin The therapeutic efficacy of Doxepin can be decreased when used in combination with Mechlorethamine.Doxorubicin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Doxorubicin.Doxylamine The therapeutic efficacy of Doxylamine can be decreased when used in combination with Mechlorethamine.Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Mechlorethamine.Dyclonine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Dyclonine.Ebola Zaire vacc The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Mechlorethamine.Eculizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Eculizumab.Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Mechlorethamine.Edoxaban The risk or severity of bleeding can be increased when Edoxaban is combined with Mechlorethamine.Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Mechlorethamine.Emapalumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Emapalumab.Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Mechlorethamine.Ephedrine Mechlorethamine may increase the neuromuscular blocking activities of Ephedrine.Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Mechlorethamine.Epoprostenol The risk or severity of bleeding can be increased when Epoprostenol is combined with Mechlorethamine.Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Mechlorethamine.Eribulin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Eribulin.Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Mechlorethamine.Escitalopram The therapeutic efficacy of Escitalopram can be decreased when used in combination with Mechlorethamine.Esmolol Mechlorethamine may increase the bradycardic activities of Esmolol.Estramustine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Estramustine.Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Mechlorethamine.Ethyl chloride The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Ethyl chloride.Etidocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Etidocaine.Etoposide The risk or severity of adverse effects can be increased when Etoposide is combined with Mechlorethamine.Everolimus The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Everolimus.Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Mechlorethamine.Fenoterol The therapeutic efficacy of Fenoterol can be decreased when used in combination with Mechlorethamine.Fesoterodine The therapeutic efficacy of Fesoterodine can be decreased when used in combination with Mechlorethamine.Filgotinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Filgotinib.Fingolimod Mechlorethamine may increase the immunosuppressive activities of Fingolimod.Flavoxate The therapeutic efficacy of Flavoxate can be decreased when used in combination with Mechlorethamine.Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Mechlorethamine.Flucytosine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Flucytosine.Fludarabine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Fludarabine.Fludrocortisone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fludrocortisone.Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Mechlorethamine.Flumethasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Flumethasone.Flunisolide The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Flunisolide.Fluocinolone acetonide The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluocinolone acetonide.Fluocinonide The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluocinonide.Fluocortolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluocortolone.Fluorometholone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluorometholone.Fluorouracil The risk or severity of adverse effects can be increased when Fluorouracil is combined with Mechlorethamine.Fluoxetine The therapeutic efficacy of Fluoxetine can be decreased when used in combination with Mechlorethamine.Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Mechlorethamine.Fluprednisolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluprednisolone.Fluticasone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluticasone.Fluticasone furoate The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluticasone furoate.Fluticasone prop The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Fluticasone propionate.Fondaparinux The risk or severity of bleeding can be increased when Fondaparinux is combined with Mechlorethamine.Gallamine triethio The therapeutic efficacy of Gallamine triethiodide can be decreased when used in combination with Mechlorethamine.Gallium nitrate The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Gallium nitrate.Gemcitabine The risk or severity of adverse effects can be increased when Gemcitabine is combined with Mechlorethamine.Gemtuzumab oz The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Mechlorethamine.Glatiramer The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Glatiramer.Glycopyrronium The therapeutic efficacy of Glycopyrronium can be decreased when used in combination with Mechlorethamine.Golimumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Golimumab.Guselkumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Guselkumab.Haemophilus The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Mechlorethamine.Heparin The risk or severity of bleeding can be increased when Heparin is combined with Mechlorethamine.Hepatitis A Vaccine The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Mechlorethamine.Hepatitis B Vaccine The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Mechlorethamine.Hexafluronium The therapeutic efficacy of Hexafluronium can be decreased when used in combination with Mechlorethamine.Hexocyclium The therapeutic efficacy of Hexocyclium can be decreased when used in combination with Mechlorethamine.Homatropine methy The therapeutic efficacy of Homatropine methylbromide can be decreased when used in combination with Mechlorethamine.Human adenovirus The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Mechlorethamine.Hydrochlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Mechlorethamine.Hydrocortisone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Hydrocortisone.Hydrocortisone ac The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Hydrocortisone acetate.Hydrocortisone bu The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Hydrocortisone butyrate.Hydrocortisone cy The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Hydrocortisone cypionate.Hydrocortisone su The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Hydrocortisone succinate.Hydroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Mechlorethamine.Hydroxychloroquine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Hydroxychloroquine.Hydroxyurea The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Hydroxyurea.Hyoscyamine The therapeutic efficacy of Hyoscyamine can be decreased when used in combination with Mechlorethamine.Ibritumomab ti The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Mechlorethamine.Ibrutinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ibrutinib.Icosapent ethyl The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Mechlorethamine.Idarubicin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Idarubicin.Idelalisib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Idelalisib.Ifosfamide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ifosfamide.Iloprost The risk or severity of bleeding can be increased when Iloprost is combined with Mechlorethamine.Imatinib The risk or severity of adverse effects can be increased when Imatinib is combined with Mechlorethamine.Imipramine The therapeutic efficacy of Imipramine can be decreased when used in combination with Mechlorethamine.Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Mechlorethamine.Inebilizumab The risk or severity of infection can be increased when Mechlorethamine is combined with Inebilizumab.Infliximab The risk or severity of adverse effects can be increased when Infliximab is combined with Mechlorethamine.Influenza A vi The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A virus The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A vir The therapeutic efficacy of Influenza A virus A/California/7/2009 (H1N1) live (attenuated) antigen can be decreased when used in combination with Mechlorethamine.Influenza A virus The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A viru The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A The therapeutic efficacy of Influenza A virus A/Perth/16/2009 (H3N2) live (attenuated) antigen can be decreased when used in combination with Mechlorethamine.Influenza A v The therapeutic efficacy of Influenza A virus A/Uruguay/716/2007(H3N2) antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A virus The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Influenza A The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Influenza B virus The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Influenza B The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Influenza B virus The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Influenza B virus B The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mechlorethamine.Interferon alfa-2a The risk or severity of adverse effects can be increased when Interferon alfa-2a is combined with Mechlorethamine.Interferon alfa-2b The risk or severity of adverse effects can be increased when Interferon alfa-2b is combined with Mechlorethamine.Interferon alfa-n1 The risk or severity of adverse effects can be increased when Interferon alfa-n1 is combined with Mechlorethamine.Interferon alfa-n3 The risk or severity of adverse effects can be increased when Interferon alfa-n3 is combined with Mechlorethamine.Interferon alfacon-1 The risk or severity of adverse effects can be increased when Interferon alfacon-1 is combined with Mechlorethamine.Interferon beta-1b The risk or severity of adverse effects can be increased when Interferon beta-1b is combined with Mechlorethamine.Interferon gamma-1b The risk or severity of adverse effects can be increased when Interferon gamma-1b is combined with Mechlorethamine.Ipratropium The therapeutic efficacy of Ipratropium can be decreased when used in combination with Mechlorethamine.Irinotecan The risk or severity of adverse effects can be increased when Irinotecan is combined with Mechlorethamine.Isoflurane The therapeutic efficacy of Isoflurane can be decreased when used in combination with Mechlorethamine.Isopropamide The therapeutic efficacy of Isopropamide can be decreased when used in combination with Mechlorethamine.Ixabepilone The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ixabepilone.Ixekizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ixekizumab.Janssen COVID-19 Vaccine The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Mechlorethamine.Japanese encepha The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Mechlorethamine.Labetalol Mechlorethamine may increase the bradycardic activities of Labetalol.Leflunomide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Leflunomide.Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Mechlorethamine.Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Mechlorethamine.Levacetylmethadol The therapeutic efficacy of Levacetylmethadol can be decreased when used in combination with Mechlorethamine.Levobetaxolol Mechlorethamine may increase the bradycardic activities of Levobetaxolol.Levobupivacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Levobupivacaine.Lidocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Lidocaine.Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Mechlorethamine.Lipegfilgrastim Mechlorethamine may increase the myelosuppressive activities of Lipegfilgrastim.Lomustine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Lomustine.Lopinavir The serum concentration of Mechlorethamine can be increased when it is combined with Lopinavir.Magnesium The serum concentration of Magnesium can be decreased when it is combined with Mechlorethamine.Maprotiline The therapeutic efficacy of Maprotiline can be decreased when used in combination with Mechlorethamine.Measles virus v The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Mechlorethamine.Mebeverine The therapeutic efficacy of Mebeverine can be decreased when used in combination with Mechlorethamine.Mecamylamine The therapeutic efficacy of Mecamylamine can be decreased when used in combination with Mechlorethamine.Meclizine The therapeutic efficacy of Meclizine can be decreased when used in combination with Mechlorethamine.Meloxicam The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Meloxicam.Melphalan The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Melphalan.Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Mechlorethamine.Mepenzolate The therapeutic efficacy of Mepenzolate can be decreased when used in combination with Mechlorethamine.Mepivacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Mepivacaine.Mepolizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mepolizumab.Meprednisone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Meprednisone.Mercaptopurine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mercaptopurine.Methacholine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Methacholine.Methadone The therapeutic efficacy of Methadone can be decreased when used in combination with Mechlorethamine.Methantheline The therapeutic efficacy of Methantheline can be decreased when used in combination with Mechlorethamine.Methimazole The risk or severity of adverse effects can be increased when Methimazole is combined with Mechlorethamine.Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Mechlorethamine.Methotrimeprazine The therapeutic efficacy of Methotrimeprazine can be decreased when used in combination with Mechlorethamine.Methoxy polyet The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Mechlorethamine.Methscopolamine The therapeutic efficacy of Methscopolamine can be decreased when used in combination with Mechlorethamine.Methscopolamine br The therapeutic efficacy of Methscopolamine bromide can be decreased when used in combination with Mechlorethamine.Methylphenobarbital The therapeutic efficacy of Methylphenobarbital can be decreased when used in combination with Mechlorethamine.Methylprednisolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Methylprednisolone.Methylpredniso The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Methylprednisolone aceponate.Methylprednisol The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Methylprednisolone hemisuccinate.Metixene The therapeutic efficacy of Metixene can be decreased when used in combination with Mechlorethamine.Metocurine The therapeutic efficacy of Metocurine can be decreased when used in combination with Mechlorethamine.Metocurine iodide The therapeutic efficacy of Metocurine iodide can be decreased when used in combination with Mechlorethamine.Metoprolol Mechlorethamine may increase the bradycardic activities of Metoprolol.Mirabegron Mechlorethamine may increase the neuromuscular blocking activities of Mirabegron.Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Mechlorethamine.Mitoxantrone The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mitoxantrone.Mivacurium The therapeutic efficacy of Mivacurium can be decreased when used in combination with Mechlorethamine.Moderna COVID-19 The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Mechlorethamine.Modified vaccinia a The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Mechlorethamine.Mometasone fu The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Mometasone furoate.Monomethyl fum The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Monomethyl fumarate.Mosunetuzumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mosunetuzumab.Moxisylyte Mechlorethamine may increase the neuromuscular blocking activities of Moxisylyte.Mumps virus stra The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Mechlorethamine.Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Mechlorethamine.Mycophenolate m The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Mechlorethamine.Mycophenolic acid The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mycophenolic acid.Nadolol Mechlorethamine may increase the bradycardic activities of Nadolol.Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Mechlorethamine.Natalizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Natalizumab.Nebivolol Mechlorethamine may increase the bradycardic activities of Nebivolol.Nelarabine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Nelarabine.Nicardipine The therapeutic efficacy of Nicardipine can be decreased when used in combination with Mechlorethamine.Nicotine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Nicotine.Nilotinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Nilotinib.Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Mechlorethamine.Nortriptyline The therapeutic efficacy of Nortriptyline can be decreased when used in combination with Mechlorethamine.Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Mechlorethamine.Obinutuzumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Obinutuzumab.Ocrelizumab Ocrelizumab may increase the immunosuppressive activities of Mechlorethamine.Ofatumumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ofatumumab.Olanzapine The therapeutic efficacy of Olanzapine can be decreased when used in combination with Mechlorethamine.Olaparib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Olaparib.Orphenadrine The therapeutic efficacy of Orphenadrine can be decreased when used in combination with Mechlorethamine.Ouabain Ouabain may decrease the cardiotoxic activities of Mechlorethamine.Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Mechlorethamine.Oxetacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Oxetacaine.Oxprenolol Mechlorethamine may increase the bradycardic activities of Oxprenolol.Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Oxybuprocaine.Oxybutynin The therapeutic efficacy of Oxybutynin can be decreased when used in combination with Mechlorethamine.Oxyphencyclimine The therapeutic efficacy of Oxyphencyclimine can be decreased when used in combination with Mechlorethamine.Oxyphenonium The therapeutic efficacy of Oxyphenonium can be decreased when used in combination with Mechlorethamine.Ozanimod The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ozanimod.Paclitaxel The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Paclitaxel.Palbociclib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Palbociclib.Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Mechlorethamine.Pancuronium The therapeutic efficacy of Pancuronium can be decreased when used in combination with Mechlorethamine.Panobinostat The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Panobinostat.Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Mechlorethamine.Paroxetine The therapeutic efficacy of Paroxetine can be decreased when used in combination with Mechlorethamine.Pazopanib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pazopanib.Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Mechlorethamine.Pegcetacoplan The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pegcetacoplan.Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Mechlorethamine.Peginterferon al The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Mechlorethamine.Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Mechlorethamine.Penbutolol Mechlorethamine may increase the bradycardic activities of Penbutolol.Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Mechlorethamine.Pentobarbital The therapeutic efficacy of Pentobarbital can be decreased when used in combination with Mechlorethamine.Pentolinium The therapeutic efficacy of Pentolinium can be decreased when used in combination with Mechlorethamine.Pentosan polys The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Mechlorethamine.Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Mechlorethamine.Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Mechlorethamine.Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Mechlorethamine.Pertuzumab The risk or severity of cardiotoxicity can be increased when Mechlorethamine is combined with Pertuzumab.Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Mechlorethamine.Phenobarbital The therapeutic efficacy of Phenobarbital can be decreased when used in combination with Mechlorethamine.Phenol The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Phenol.Phenprocoumon The risk or severity of bleeding can be increased when Phenprocoumon is combined with Mechlorethamine.Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Mechlorethamine.Pilocarpine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pilocarpine.Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Mechlorethamine.Pindolol Mechlorethamine may increase the bradycardic activities of Pindolol.Pipecuronium The therapeutic efficacy of Pipecuronium can be decreased when used in combination with Mechlorethamine.Pirenzepine The therapeutic efficacy of Pirenzepine can be decreased when used in combination with Mechlorethamine.Pirfenidone The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pirfenidone.Pirtobrutinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pirtobrutinib.Pizotifen The therapeutic efficacy of Pizotifen can be decreased when used in combination with Mechlorethamine.Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Mechlorethamine.Pomalidomide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pomalidomide.Ponatinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ponatinib.Ponesimod The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ponesimod.Practolol Mechlorethamine may increase the bradycardic activities of Practolol.Pralatrexate The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pralatrexate.Pramocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Pramocaine.Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Mechlorethamine.Prednisolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Prednisolone.Prednisolone a The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Prednisolone acetate.Prednisolone phos The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Prednisolone phosphate.Prednisone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Prednisone.Prednisone ac The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Prednisone acetate.Prilocaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Prilocaine.Primidone The therapeutic efficacy of Primidone can be decreased when used in combination with Mechlorethamine.Procaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Procaine.Procarbazine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Procarbazine.Procyclidine The therapeutic efficacy of Procyclidine can be decreased when used in combination with Mechlorethamine.Profenamine The therapeutic efficacy of Profenamine can be decreased when used in combination with Mechlorethamine.Promazine The therapeutic efficacy of Promazine can be decreased when used in combination with Mechlorethamine.Promethazine The therapeutic efficacy of Promethazine can be decreased when used in combination with Mechlorethamine.Propafenone Mechlorethamine may increase the bradycardic activities of Propafenone.Propantheline The therapeutic efficacy of Propantheline can be decreased when used in combination with Mechlorethamine.Proparacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Proparacaine.Propiomazine The therapeutic efficacy of Propiomazine can be decreased when used in combination with Mechlorethamine.Propiverine The therapeutic efficacy of Propiverine can be decreased when used in combination with Mechlorethamine.Propoxycaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Propoxycaine.Propranolol Mechlorethamine may increase the bradycardic activities of Propranolol.Propylthiouracil The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Mechlorethamine.Protein C The risk or severity of bleeding can be increased when Protein C is combined with Mechlorethamine.Protein S hu The risk or severity of bleeding can be increased when Protein S human is combined with Mechlorethamine.Quetiapine The therapeutic efficacy of Quetiapine can be decreased when used in combination with Mechlorethamine.Quinidine The therapeutic efficacy of Quinidine can be decreased when used in combination with Mechlorethamine.Rabies imm The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Mechlorethamine.Rab antigen, A The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Mechlorethamine.Rabi antigen, B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Mechlorethamine.Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Mechlorethamine.Rapacuronium The therapeutic efficacy of Rapacuronium can be decreased when used in combination with Mechlorethamine.Ravulizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ravulizumab.Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Mechlorethamine.Revefenacin The therapeutic efficacy of Revefenacin can be decreased when used in combination with Mechlorethamine.Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Mechlorethamine.Rilonacept The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Rilonacept.Risankizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Risankizumab.Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Mechlorethamine.Rivaroxaban The risk or severity of bleeding can be increased when Rivaroxaban is combined with Mechlorethamine.Rocuronium The therapeutic efficacy of Rocuronium can be decreased when used in combination with Mechlorethamine.Roflumilast Roflumilast may increase the immunosuppressive activities of Mechlorethamine.Ropeginterferon The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ropeginterferon alfa-2b.Ropivacaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Ropivacaine.Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Mechlorethamine.Rubella virus va The risk or severity of infection can be increased when Rubella virus vaccine is combined with Mechlorethamine.Ruxolitinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ruxolitinib.Sarilumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Sarilumab.Satralizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Satralizumab.Scopolamine The therapeutic efficacy of Scopolamine can be decreased when used in combination with Mechlorethamine.Secobarbital The therapeutic efficacy of Secobarbital can be decreased when used in combination with Mechlorethamine.Secukinumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Secukinumab.Siltuximab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Siltuximab.Siponimod The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Siponimod.Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Mechlorethamine.Sirolimus The risk or severity of adverse effects can be increased when Sirolimus is combined with Mechlorethamine.Smallpox (Vacc The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Mechlorethamine.Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Mechlorethamine.Solifenacin The therapeutic efficacy of Solifenacin can be decreased when used in combination with Mechlorethamine.Sorafenib The risk or severity of adverse effects can be increased when Sorafenib is combined with Mechlorethamine.Sotalol Mechlorethamine may increase the bradycardic activities of Sotalol.Spesolimab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Spesolimab.Streptokinase The risk or severity of bleeding can be increased when Streptokinase is combined with Mechlorethamine.Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Mechlorethamine.Succinylcholine The metabolism of Succinylcholine can be decreased when combined with Mechlorethamine.Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Mechlorethamine.Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Mechlorethamine.Sulfinpyrazone The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Mechlorethamine.Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Mechlorethamine.Sunitinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Sunitinib.Sutimlimab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Sutimlimab.Tacrolimus Tacrolimus may increase the immunosuppressive activities of Mechlorethamine.Talbutal The therapeutic efficacy of Talbutal can be decreased when used in combination with Mechlorethamine.Tamoxifen The risk or severity of cardiotoxicity can be increased when Tamoxifen is combined with Mechlorethamine.Tedizolid phosphate The risk or severity of myelosuppression can be increased when Mechlorethamine is combined with Tedizolid phosphate.Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Mechlorethamine.Temsirolimus The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Temsirolimus.Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Mechlorethamine.Teniposide The risk or severity of adverse effects can be increased when Teniposide is combined with Mechlorethamine.Teprotumumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Teprotumumab.Terfenadine The therapeutic efficacy of Terfenadine can be decreased when used in combination with Mechlorethamine.Teriflunomide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Teriflunomide.Tetracaine The risk or severity of methemoglobinemia can be increased when Mechlorethamine is combined with Tetracaine.Thalidomide The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Thalidomide.Thiopental The therapeutic efficacy of Thiopental can be decreased when used in combination with Mechlorethamine.Thiotepa The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Thiotepa.Thonzylamine The therapeutic efficacy of Thonzylamine can be decreased when used in combination with Mechlorethamine.Ticagrelor The risk or severity of bleeding can be increased when Ticagrelor is combined with Mechlorethamine.Tick-b encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Mechlorethamine.Ticlopidine The risk or severity of bleeding can be increased when Ticlopidine is combined with Mechlorethamine.Timolol Mechlorethamine may increase the bradycardic activities of Timolol.Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Mechlorethamine.Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Mechlorethamine.Tiotropium The therapeutic efficacy of Tiotropium can be decreased when used in combination with Mechlorethamine.Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Mechlorethamine.Tixocortol The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Tixocortol.Tocilizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Tocilizumab.Tofacitinib Mechlorethamine may increase the immunosuppressive activities of Tofacitinib.Tolterodine The therapeutic efficacy of Tolterodine can be decreased when used in combination with Mechlorethamine.Topotecan The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Topotecan.Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Mechlorethamine.Trabectedin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Trabectedin.Tramadol The therapeutic efficacy of Tramadol can be decreased when used in combination with Mechlorethamine.Trastuzumab Trastuzumab may increase the neutropenic activities of Mechlorethamine.Trastuzumab emt The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Trastuzumab emtansine.Tretinoin The risk or severity of adverse effects can be increased when Tretinoin is combined with Mechlorethamine.Triamcinolone The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Triamcinolone.Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Mechlorethamine.Triflupromazine The therapeutic efficacy of Triflupromazine can be decreased when used in combination with Mechlorethamine.Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Mechlorethamine.Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Mechlorethamine.Trihexyphenidyl The therapeutic efficacy of Trihexyphenidyl can be decreased when used in combination with Mechlorethamine.Trilostane The therapeutic efficacy of Mechlorethamine can be decreased when used in combination with Trilostane.Trimebutine The therapeutic efficacy of Trimebutine can be decreased when used in combination with Mechlorethamine.Trimethaphan Mechlorethamine may increase the neuromuscular blocking activities of Trimethaphan.Trospium The therapeutic efficacy of Trospium can be decreased when used in combination with Mechlorethamine.Tubocurarine Mechlorethamine may increase the neuromuscular blocking activities of Tubocurarine.Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Mechlorethamine.Typhoid Vaccine Live The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Mechlorethamine.Typhoid Vi The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Mechlorethamine.Ublituximab The risk or severity of infection can be increased when Ublituximab is combined with Mechlorethamine.Umeclidinium The therapeutic efficacy of Umeclidinium can be decreased when used in combination with Mechlorethamine.Upadacitinib The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Upadacitinib.Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Mechlorethamine.Varenicline The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Varenicline.Varicella zoster vac The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Mechlorethamine.Varicella zoster va The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Mechlorethamine.Vecuronium The therapeutic efficacy of Vecuronium can be decreased when used in combination with Mechlorethamine.Vedolizumab The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Vedolizumab.Vibrio chole antigen The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Mechlorethamine.Vilanterol The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Vilanterol.Vinblastine The risk or severity of adverse effects can be increased when Vinblastine is combined with Mechlorethamine.Vincristine The risk or severity of adverse effects can be increased when Vincristine is combined with Mechlorethamine.Vindesine The risk or severity of adverse effects can be increased when Vindesine is combined with Mechlorethamine.Vinorelbine The risk or severity of adverse effects can be increased when Vinorelbine is combined with Mechlorethamine.Voclosporin The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Voclosporin.Vorapaxar The risk or severity of bleeding can be increased when Vorapaxar is combined with Mechlorethamine.Vorinostat The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Vorinostat.Warfarin The risk or severity of bleeding can be increased when Warfarin is combined with Mechlorethamine.Ximelagatran The risk or severity of bleeding can be increased when Ximelagatran is combined with Mechlorethamine.Yellow fever vaccine The risk or severity of infection can be increased when Yellow fever vaccine is combined with Mechlorethamine.Zidovudine The risk or severity of adverse effects can be increased when Zidovudine is combined with Mechlorethamine.Ziprasidone The therapeutic efficacy of Ziprasidone can be decreased when used in combination with Mechlorethamine.Pregnancy and LactationFDA Pregnancy Category D Pregnancy Mechlorethamine can cause fetal harm when administered to a pregnant woman. There are case reports of children born with malformations in pregnant women systemically administered mechlorethamine. Mechlorethamine was teratogenic in animals after a single subcutaneous administration. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. Lactation It is not known if mechlorethamine is excreted in human milk. Due to the potential for topical or systemic exposure to VALCHLOR through exposure to the mother's skin, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Safety and effectiveness in pediatric patients have not been established.Why is this medication prescribed?

Mechlorethamine is used to treat Hodgkin's lymphoma (Hodgkin's disease) and certain types of non-Hodgkin's lymphoma (types of cancer that begin in a type of white blood cells that normally fights infection); mycosis fungoides (a type of cancer of the immune system that first appear as skin rashes); certain types of leukemia (cancer of the white blood cells), including chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML); and lung cancer. Mechlorethamine is also used to treat polycythemia vera (a disease…

How should this medicine be used?

Mechlorethamine comes as powder to be mixed with liquid to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. It may also be injected intraperitoneally (into the abdominal cavity), intrapleurally (into the chest cavity), or intrapericardially (into the lining of the heart). The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer or condition you have. Ask your pharmacist…

References

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Written by Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

Dr. Md. Harun Ar Rashid, MPH, MD, PhD, is a highly respected medical specialist celebrated for his exceptional clinical expertise and unwavering commitment to patient care. With advanced qualifications including MPH, MD, and PhD, he integrates cutting-edge research with a compassionate approach to medicine, ensuring that every patient receives personalized and effective treatment. His extensive training and hands-on experience enable him to diagnose complex conditions accurately and develop innovative treatment strategies tailored to individual needs. In addition to his clinical practice, Dr. Harun Ar Rashid is dedicated to medical education and research, writing and inventory creative thinking, innovative idea, critical care managementing make in his community to outreach, often participating in initiatives that promote health awareness and advance medical knowledge. His career is a testament to the high standards represented by his credentials, and he continues to contribute significantly to his field, driving improvements in both patient outcomes and healthcare practices. Born and educated in Bangladesh, Dr. Rashid earned his BPT from the University of Dhaka before pursuing postgraduate training internationally. He completed his MD in Internal Medicine at King’s College London, where he developed a special interest in inflammatory arthritis and metabolic bone disease. He then undertook a PhD in Orthopedic Science at the University of Oxford, conducting pioneering research on cytokine signaling pathways in rheumatoid arthritis. Following his doctoral studies, Dr. Rashid returned to clinical work with a fellowship in interventional pain management at the Rx University School of Medicine, refining his skills in image-guided joint injections and minimally invasive pain-relief techniques.