Chlorambucil (Leukeran)

Warnings: There are several serious side effects associated with Chlorambucil. Although it is meant to treat cancer, it can also cause other forms of cancer to develop in your body. The ability for you to fight infection may also be affected with this medication as it lowers the functionality of your bone marrow. Contact your doctor immediately if you develop signs of an infection while taking this medication (chills, persistent cough, sore throat or a fever), lumps, swollen glands, unusual fatigue and unusual bleeding and bruising while on this medication.  

You can also become sterile from taking this medication. You may experience damage of the genes and birth defects after you have used this treatment.  

Indications: Chlorambucil is made to treat certain types of cancer, such as leukemia and lymphoma. It is a drug that is commonly called chemotherapy that stops or slows cell growth.

There are also some uses that the manufacturer has not released it to be used for, so use only if your doctor prescribes it to you. The medication has been used for certain blood diseases and some types of kidney cancer in children that have little to no results on other medications.  

In addition, Chlorambucil is used to treat the following cancers: 

• Hodgkin's disease
• breast cancer 
• ovarian cancer  
• testicular cancer 
• choriocarcinoma, an aggressive form of cancer that occurs in a woman's uterus 
• Thrombocythemia, a blood disorder in which the body produces too many platelets (thrombocytes).  

Storage: Keep Chlorambucil tightly closed and out of reach of children. Keep the medication in a dry place at room temperature and away from excess heat and humidity. It is not recommended to keep Chlorambucil in the bathroom. For more information, talk to your physician or pharmacist.  

Dosage: Chlorambucil is taken by mouth, the amount is prescribed by your doctor. The patient is usually advised to drink plenty of fluids to avoid some side effects of the drug. The dosage that your doctor will prescribe will be based on your weight, height and response to therapy. You shouldn’t try to increase your dosage, you will not see results any sooner and you will be putting yourself at risk for serious side effects.

This drug should not be handled by pregnant women or women that plan on becoming pregnant in the future, as it can be absorbed through the skin.

Overdose: Chlorambucil overdose can be fetal. The drug can cause serious health problems including the development of other types of cancers. If you think you have taken an overdose of the drug, you should immediately contact your doctor or the poison control center nearest you. A health care provider can give you an antidote, symptomatic treatment or blood transfusion to slow or stop the toxic effects of the medication. 

Missing dose: Chlorambucil can be taken one or several times per day. If you have been recommended to take the drug once a day and you miss a dose until the next day, do not double the dose. If you have been recommended to take medication several times a day and forgotten until the next dose, skip the missed dose; do not double the dose. Don’t ever take less or more of the prescribed dose.  

Contraindications: You should tell your doctor of all the medications that you are on. You should also tell them of any allergies that you aware of, as some of the inactive ingredients may cause serious allergic reactions.  

Do not have any immunizations while taking Chlorambucil. Avoid contact with anyone that has had a recent oral polio vaccination. Avoid any contact sports as there is increased risk of serious bruising and bleeding. Women that plan on becoming pregnant or are pregnant should not use this medication because of the increased risk of side effects.

This medication may not be recoomended to patients who have the following:

• blood disorders: bleeding disorders, platelet disorders, hemophilia and anemia
• head injury  
• recent or ongoing radiation therapy  
• seizures 
• certain viral infections: chickenpox, cold sores, herpes, etc.
• Unusual or allergic reaction to Chlorambucil or any of its components.  

Mechanism of action (MOA): Chlorambucil works by modifying the structure of the constituents of the cancer cells (DNA), thus slowing or stopping their proliferation. 

Interactions: Your healthcare professionals should know the possible interactions that can arise while taking this treatment. Tell your doctor if you are taking the drugs called nalidixic acid and cyclosporin, an immunosuppressive agent; serious side effects can occur when taking them with Chlorambucil. Your doctor should also be aware of any drugs that can cause seizures while using this medication.  

In addition, talk to your doctor before taking any of the following : 

• vitamin supplements 
• St. John wort 
• acetaminophen 
• ketoprofen  
• aspirin 
• ibuprofen
• Naproxen . 

Side effects: In addition to causing death of cancer cells, Chlorambucil tends to interfere with healthy cells that multiply quickly, and cause adverse effects; the most common chlorambucil side effects of include:    

• fatigue  
• hair loss
• dry skin
• mouth blistering 
• decreased appetite  
• constipation or diarrhea 
• skin disorders: rash, itching
• Taste changes or metallic food taste.  

Although rare, Chlorambucil can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:    

• persistent fever 
• sore throat 
• red urine 
• dizziness  
• confusion 
• severe depression
• congestion  
• shortness of breath or breathing discomfort 
• fainting (temporary loss of consciousness)
• unusual bruising or bleeding 
• Infection, which can be indicated by fever or sore throat.