Mechlorethamine - Uses, Dosage, Side Effects, Interaction

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. Given parenterally in combination with other antineoplastic agents it was associated with low rates of serum enzyme elevations during therapy, but mechlorethamine has not been implicated specifically in cases of an acute, clinically apparent injury.

Mechlorethamine is a synthetic agent related to sulphur mustard with antineoplastic and immunosuppressive properties. Nitrogen mustard (a member of a family of chemotherapy agents including cyclophosphamide and chlorambucil) is an irritant and carcinogenic agent metabolized to a highly reactive ethylene ammonium derivative; the ethylene ammonium derivative alkylates DNA and inhibits DNA replication. This agent also exhibits lymphocytic properties. (NCI04)

Mechlorethamine Hydrochloride is the hydrochloride salt of mechlorethamine, nitrogen mustard, and an analog of sulfur mustard, with antineoplastic and immunosuppressive activities. Mechlorethamine is metabolized to an unstable, highly reactive ethylenimine intermediate that alkylates DNA, particularly the 7 nitrogen of guanine residues, resulting in DNA base pair mismatching, DNA interstrand crosslinking, the inhibition of DNA repair and synthesis, cell-cycle arrest, and apoptosis. This agent also exhibits lymphocytic properties.

Mechlorethamine is only found in individuals that have used or taken this drug. It is a vesicant and necrotizing irritant destructive to mucous membranes. It was formerly used as a war gas. Hydrochloride is used as an antineoplastic in Hodgkin’s disease and lymphomas. It causes severe gastrointestinal and bone marrow damage. 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.

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.

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

DRUG	INTERACTION
Abatacept	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 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.

References