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Valchlor
Valchlor (generic name: mechlorethamine gel) is a topical chemotherapy agent used to treat patients with stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma (CTCL), a rare form of non-Hodgkin lymphoma that primarily affects the skin. Valchlor is applied directly to the skin and helps slow the growth of cancerous T-cells, reducing lesions and symptoms associated with CTCL.
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Frequently Asked Questions
How long does it take for Valchlor to work?
Improvements in skin lesions may take several weeks to months. Regular follow-up with your healthcare provider is important to monitor your progress.
Can I apply Valchlor to healthy skin?
No, Valchlor should only be applied to the affected areas of the skin. Avoid applying it to healthy skin, as it can cause irritation and damage.
What should I do if I miss a dose of Valchlor?
If you miss a dose, apply it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not apply extra gel to make up for a missed dose.
Can I use other skin products while using Valchlor?
Consult your healthcare provider before using any other skin products, as certain lotions, creams, or medications may increase the risk of skin irritation when used with Valchlor.
Is Valchlor safe to use during pregnancy?
No, Valchlor can harm an unborn baby and should not be used during pregnancy. Women of childbearing potential should use effective contraception while using Valchlor.
Comprehensive Drug Guide
How Does Valchlor Work?
Valchlor contains mechlorethamine, an alkylating agent that works by binding to the DNA of rapidly dividing cancer cells, disrupting their ability to replicate. This slows down or stops the growth of abnormal T-cells in the skin, reducing the symptoms of cutaneous T-cell lymphoma.
Common Dosages
- 0.016% topical gel
Typical Dosing
- Apply a thin layer of Valchlor to the affected areas of the skin once daily. The gel should be applied at least 4 hours before bathing or showering, and hands should be thoroughly washed after application.
- Avoid applying to the face or mucous membranes (such as inside the nose or mouth).
Typical Dosing
FDA Approved Indications
- Topical treatment of stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma (CTCL) in patients who have received prior skin-directed therapy.
Who Shouldn't Take Valchlor?
- Known hypersensitivity to mechlorethamine or any component of the gel.
- Pregnancy or breastfeeding, as Valchlor may harm an unborn baby or be passed through breast milk.
Advice From The Pharmacist
- Apply Valchlor at the same time each day, using only a thin layer on the affected areas of the skin. Avoid applying the gel to healthy skin or mucous membranes (eyes, mouth, nose, or genitals).
- Avoid exposure to sunlight on treated areas, as the medication may increase sensitivity to the sun.
- Wash your hands thoroughly with soap and water after applying the gel, and avoid contact with other people until the gel has dried.
- Do not cover the treated area with bandages or tight clothing, as this can increase absorption and the risk of side effects.
- Valchlor is flammable, so avoid using it near open flames or while smoking.
Side Effects of Valchlor
Common Side Effects
- Skin irritation (redness, itching, or swelling at the application site)
- Blistering or peeling of the skin
- Dry skin
Uncommon/Severe Side Effects
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Severe skin reactions, including ulceration or open sores
Risks and Warnings of Valchlor
- Skin Reactions: Valchlor can cause significant skin reactions, such as redness, blistering, and peeling. If these reactions are severe, contact your healthcare provider immediately. Prolonged or excessive use of the gel can increase the risk of skin damage.
- Carcinogenic Potential: As an alkylating agent, Valchlor has the potential to cause secondary malignancies (other cancers) with long-term use. Patients should be monitored for any signs of new skin lesions or changes in existing ones.
- Pregnancy and Breastfeeding: Valchlor can cause harm to an unborn baby, and women who are pregnant or planning to become pregnant should avoid using the medication. Breastfeeding mothers should also avoid using Valchlor due to the risk of harm to the infant.
Interactions with Valchlor
Common Drug Interactions
- Topical corticosteroids: Using other topical treatments, especially corticosteroids, on the same area as Valchlor may increase the risk of skin irritation. Always consult your healthcare provider before combining treatments.
- Sun exposure: Treated skin may become more sensitive to sunlight, so it is important to use sunscreen or protective clothing when outdoors.
Alternatives to Valchlor
- Topical corticosteroids: Used to manage inflammation and itching in early stages of CTCL.
- Bexarotene gel (Targretin): Another topical treatment for early-stage cutaneous T-cell lymphoma.
- Phototherapy: Ultraviolet light therapy (PUVA or UVB) is often used to treat CTCL and can be combined with other treatments.
