VALCHLOR

By Gary M. White, MD


Valchlor is mechlorethamine gel 0.016% (nitrogen mustard), the first and only FDA-approved topical formulation of mechlorethamine.

Contraindications

Known severe hypersensitivity to mechlorethamine.

Dosing and Application

Apply a thin film once daily to affected areas of the skin. Caregivers must wear disposable nitrile gloves when applying Valchlor. Wash hands thoroughly after.

Side Effects

Safety Warnings

1.  Don't get in eyes.
2.  Keep away from others
3.  Watch for skin irritation, swelling, etc.
4.  Monitor patients for non-melanoma skin cancer during and after treatment.
5.  Patients should not become pregnant on the medication.
6.  Potentially flammable. Avoid fire, flame.
7.  Needs to be refrigerated before and after use. 

Concern about Malignancy

There have been several case reports of SCC developing in patients with CTCL treated in genital skin with topical nitrogen mustard [JAAD 1986;14;1029]. Concomitant electron beam therapy or PUVA may add to the risk. Caution should be exercised in the use of nitrogen mustard in the genital area.

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