chlorambucil

Derm: dermatitis, rash

GI: nausea, stomatitis (rare), vomiting

GU: ↓fertility

Hemat: anemia, LEUKOPENIA, thrombocytopenia

Metab: hyperuricemia

Resp: pulmonary fibrosis

Misc: allergic reactions, second malignancy

Interactions ⬆ ⬇

Drug-drug:

Additive myelosuppression with other bone marrow depressants (antineoplastics) or immunosuppressant agents.
May ↓ antibody response to live-virus vaccines and ↑ the risk of adverse reactions.

Drug-Natural Products:

Astragalus, echinacea, and melatonin may interfere with immunosuppression.

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

PO (Adults ): 0.1–0.2 mg/kg/day (3–6 mg/m²/day) (usual range 4–10 mg/day as a single dose or in divided doses); then adjust dose on basis of blood counts; or 0.4 mg/kg (12 mg/m²) twice weekly; ↑ by 0.1 mg/kg (3 mg/m²) every 2 wk; then adjust as necessary.
PO Geriatric Patients ): Initial dose should not be more than 2–4 mg/day.
PO (Children ): 0.1–0.2 mg/kg/day (4.5 mg/m²/day) as a single dose or in divided doses.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

An alkylating agent that interferes with cellular protein synthesis (cell-cycle phase-nonspecific).

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: alkylating agents

Pharmacokinetics ⬆ ⬇

Absorption: Rapidly and completely absorbed from the GI tract.

Distribution: Well distributed to tissues.

Protein Binding: 99%.

Metabolism/Excretion: Extensively metabolized by the liver. Primarily excreted in urine as metabolites.

Half-Life: 1.5 hr.

Time/Action Profile ⬆ ⬇

(effects on WBCs)

ROUTE	ONSET	PEAK	DURATION
PO	7–14 days	7–14 days	14–28 days

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed, even if nausea or vomiting is a problem. Consult health care provider if vomiting occurs shortly after dose is taken. If a dose is missed and the medication is ordered daily, take when remembered later that day. If ordered more frequently, take as soon as possible unless almost time for next dose. Do not double doses.
Instruct patient to report unusual bleeding or bruising. Advise patient of thrombocytopenia precautions (use soft toothbrush, electric razor, and avoid falls; do not drink alcoholic beverages or take medication containing aspirin or NSAIDs because they may precipitate GI bleeding).
Caution patient to avoid crowds and persons with known infections. Health care provider should be informed immediately if symptoms of infection (fever, sore throat, chills, cough, hoarseness, lower back or side pain, difficult or painful urination) or rash occurs.
Instruct patient to inspect oral mucosa for redness and ulceration. If mouth sores occur, advise patient to use sponge brush and rinse mouth with water after eating and drinking. Stomatitis may require treatment with opioid analgesics.
Advise patients on long-term therapy to notify health care provider immediately if cough, shortness of breath, and fever occur.
Instruct patient to inform health care provider if nausea and vomiting persist. Antiemetics may be used, although these side effects usually last <1 day and tend to ↓ with continued therapy.
Discuss with patient the possibility of hair loss. Explore methods of coping.
Rep: May cause fetal harm. Advise patient to use reliable form of contraception during therapy. Instruct patient to inform health care provider if pregnancy is planned or suspected and to avoid breastfeeding during therapy. May ↓ fertility.
Instruct patient not to receive any vaccinations without advice of health care provider.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

46014- Excella GmbH & Co. KG
- 46014-6102-
  - 46014-6102-5- 25 TABLET, FILM COATED in 1 BOTTLE (46014-6102-5)

50683- AMERICAN PACIFIC CORPORATION
- 50683-0384-
  - 50683-0384-1- 5 kg in 1 DRUM (50683-0384-1)

71052- Darmerica
- 71052-212-
  - 71052-212-00- 500 g in 1 CONTAINER (71052-212-00)

71052- Darmerica
- 71052-212-
  71052-212-01- 1 g in 1 CONTAINER (71052-212-01)

71052- Darmerica
- 71052-212-
  71052-212-03- 10 g in 1 BOTTLE (71052-212-03)

71052- Darmerica
- 71052-212-
  71052-212-05- 5 g in 1 CONTAINER (71052-212-05)

71052- Darmerica
- 71052-212-
  71052-212-10- 100 g in 1 CONTAINER (71052-212-10)

71052- Darmerica
- 71052-212-
  71052-212-50- 50 g in 1 CONTAINER (71052-212-50)

76055- Sionc Pharmaceutical Private Limited
- 76055-0025-
  76055-0025-1- 25 kg in 1 DRUM (76055-0025-1)

80725- Waylis Therapeutics LLC
- 80725-610- LEUKERAN
  80725-610-25- 25 TABLET, FILM COATED in 1 BOTTLE (80725-610-25)

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇