Acute Porphyria Drug Database

L01AA05 - Chlormethine
Not porphyrinogenic
NP

Rationale
Chlormethine is not a substrate for CYP P450, and is therefore not porphyrinogenic.
Chemical description
Chlormethine (mechlorethamine) is a nitrogen analog of sulfur mustard that is very soluble in water and soluble in alcohol.
Therapeutic characteristics
Chlormethine hydrochloride has been used in the treatment of advanced Hodgkins disease and also been tried in non-Hodgkins lymphomas, notably mycosis fungoides, and other malignancies. It is administered intravenously. Common adverse reactions of chlormethine that can be confused with an acute porphyric attack are severe nausea and vomiting that may begin within an hour of injection of the drug and last for some hours. Side effects as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
On intravenous injection, chlormethine is rapidly converted to a reactive ethyleneimmonium ion. It usually disappears from the blood in a few minutes. A very small proportion is excreted unchanged in the urine.
IPNet drug reports
No.

References

  1. Drug reference publications
  2. McEvoy GK, editor. Mechlorethamine Hydrochloride. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (September 2009). #3308
  3. Sweetman SC, editor. Martindale: The complete drug reference. Chlormethine Hydrochloride. Pharmaceutical Press 2009. #3309

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