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Chlorambucil

    Brands

    DEA Class; Rx

    Common Brand Names; Leukeran

    • Antineoplastics, Alkylating

    Oral alkylating agent
    Approved for use as palliative treatment of chronic lymphocytic leukemia, Hodgkin lymphoma, and certain non-Hodgkin’s lymphomas including lymphosarcoma and giant follicular lymphoma
    Has black box warnings for severe myelosuppression, carcinogenicity, teratogenicity, and infertility

    Indicated for the treatment of chronic lymphocytic leukemia (CLL).

    For the palliative treatment of Hodgkin lymphoma.

    Hypersensitivity or resistance; demonstrated resistance to chlorambucil previously

    • Neutropenia (25-33%)
    • Anemia
    • Leukopenia
    • Thrombocytopenia
    • Seizures
    • Hallucinations
    • Peripheral neuropathy
    • Nausea
    • Vomiting
    • Pulmonary fibrosis
    • GI effects
    • Leukemia
    • Myelosuppression
    • Hyperuricemia
    • Infertility
    • Hepatotoxicity & jaundice
    • Type I hypersensitivity
    • Rash
    • Stevens-Johnson syndrome (rare)
    • Toxic epidermal necrosis (rare)
    • Urticaria

    History of seizures; head trauma; those receiving other potentially epileptogenic drugs

    Potentially mutagenic, carcinogenic & teratogenic; avoid pregnancy

    Can cause infertility

    Severely myelosuppressive

    May need lower dosages in liver failure

    Beware of cross-hypersensitivity w/ other alkylating agents

    Reduce dose in preexisting myelosuppressive situations or if WBC/Plt counts fall below normal

    If used within 4 week of radiation/cytotoxic chemotherapy

    Avoid pregnancy

    Pregnancy Category: D

    Lactation: not known if excreted in breast milk; do not nurse

    Adults

    The maximum dosage is dependent on indication, response, and toxicity.

    Geriatric

    The maximum dosage is dependent on indication, response, and toxicity.

    Chlorambucil 

    tablet

    • 2mg