THE DOSAGE OF MUSTARGEN VARIES WITH THE CLINICAL SITUATION, THE THERAPEUTIC RESPONSE AND THE MAGNITUDE OF HEMATOLOGIC DEPRESSION. A TOTAL DOSE OF 0.4 MG/KG OF BODY WEIGHT FOR EACH COURSE USUALLY IS GIVEN EITHER AS A SINGLE DOSE OR IN DIVIDED DOSES OF 0.1 TO 0.2 MG/KG PER DAY. DOSAGE SHOULD BE BASED ON IDEAL DRY BODY WEIGHT. THE PRESENCE OF EDEMA OR ASCITES MUST BE CONSIDERED.
SUBSEQUENT COURSES SHOULD NOT BE GIVEN UNTIL THE PATIENT HAS RECOVERED HEMATOLOGICALLY FROM THE PREVIOUS COURSE.
INTRACAVITARY USE:
IF MUSTARGEN IS GIVEN BY THE INTRACAVITARY ROUTE, THE PUBLISHED ARTICLES CONCERNING SUCH USE SHOULD BE CONSULTED. USED ONLY WHEN MALIGNANT CELLS ARE DEMONSTRATED IN THE EFFUSION. INTRACAVITARY INJECTION IS NOT RECOMMENDED WHEN THE ACCUMULATED FLUID IS CHYLOUS IN NATURE, SINCE RESULTS ARE LIKELY TO BE POOR. PARACENTESIS IS FIRST PERFORMED WITH MOST OF THE FLUID BEING REMOVED FROM THE PLEURAL OR PERITONEAL CAVITY.
THE USUAL DOSE OF NITROGEN MUSTARD FOR INTRACAVITARY INJECTION IS 0.4 MG/KG OF BODY WEIGHT, THOUGH 0.2 MG/KG (OR 10 TO 20 MG) HAS BEEN USED BY THE INTRAPERICARDIAL ROUTE. THE POSITION OF THE PATIENT SHOULD BE CHANGED EVERY 5 TO 10 MINUTES FOR AN HOUR AFTER INJECTION TO OBTAIN MORE UNIFORM DISTRIBUTION OF THE DRUG THROUGHOUT THE SEROUS CAVITY. THE REMAINING FLUID MAY BE REMOVED FROM THE PLEURAL OR PERITONEAL CAVITY BY PARACENTESIS 24 TO 36 HOURS LATER.
Administration:
BY THE INTRAVENOUS OR INTRACAVITARY ROUTES. ADMINISTERED INTRAPLEURALLY, INTRAPERITONEALLY, OR INTRAPERICARDIALLY ALSO FOR THE PALLIATIVE TREATMENT OF METASTATIC CARCINOMA RESULTING IN EFFUSION.