Chemotherapy Patient Resource Area

Chlorambucil/Leukeran^®

Drug
Chlorambucil (generic name) is manufactured as Leukeran^® (trade name) (GlaxoSmithKline, Research Triangle Park, NC).

Action
Chlorambucil slows or stops the growth of cancer cells. It is a type of drug called an alkylating agent and is used to treat lymphoma, Hodgkin's disease, and chronic lymphocytic leukemia. It also may be used to treat other cancers and disorders, such as ovarian cancer, hairy cell leukemia, nephrotic syndrome (a kidney disorder), and Waldenström's macroglobulinemia (a blood disorder).

What does the drug look like?
Chlorambucil is supplied as round, brown, film-coated, 2-mg tablets.

How long will I take the drug?
The length of treatment varies and depends on your diagnosis and how well your body responds to treatment.

How do I take the drug?
Chlorambucil is taken by mouth once a day for 3-6 weeks. The dose of chlorambucil is based on your body weight and is determined by your doctor. Your doctor and pharmacist will tell you how many tablets to take each day and how many days you will need to take them. Take your daily dose of chlorambucil all at once. Swallow each tablet whole; do not chew them. Your dose may be adjusted during therapy, and the number of tablets you need to take may change, so follow all directions and medicine labels carefully. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you accidentally take too many pills or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature, away from excess heat and moisture (do not store on a windowsill or in a bathroom). Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Chlorambucil lowers the number of white blood cells in your blood. Your complete blood count (CBC) will be monitored frequently while you receive this drug. This drug increases your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination.
• Chlorambucil temporarily lowers the number of red blood cells in your blood, which carry oxygen, and may cause you to feel tired and lack energy. Conserve your energy, get adequate rest, and enlist help in carrying out daily activities (such as meal preparation) as needed. If you feel unusually tired, if your skin and mucous membranes (lining of eyes and mouth) appear unusually pale, or if you experience unusual or heavy bleeding, contact your doctor immediately, as these may be signs of anemia (low red blood cell count).
• Chlorambucil also lowers the number of platelets in your blood, which are necessary for proper blood clotting. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing.
• Chlorambucil sometimes causes mouth sores. Avoid spicy foods and do not use mouthwash, because it may contain alcohol and worsen mouth pain. Your healthcare providers may give you suggestions on how to care for your mouth or manage mouth sores, and these directions should be followed carefully.
• Rarely, allergic reactions, characterized by rash, itchy skin, and swelling of tissues, have been reported following initial and subsequent dosing with chlorambucil. Very rarely, skin rash progresses to cover large areas of the body and leads to peeling of the skin. Notify your doctor immediately if you develop a skin rash, itching, or swelling while taking chlorambucil.
• Chlorambucil can cause fetal harm when administered to a pregnant woman. Women of childbearing potential should not become pregnant while taking this drug.
• Chlorambucil may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you must use a reliable birth control method and not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or would like to become pregnant need to discuss this with their doctors before taking this drug, because sterility is a possible side effect.
• Chlorambucil has been associated with the development of other types of cancers years after treatment. Discuss this potential risk of developing a new cancer with your doctor.

Drug interactions
When you are taking chlorambucil, it is important that you let your doctor know if you are taking antithyroid medicine (medicine for overactive thyroid), interferon, ganciclovir, zidovudine, or steroids. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Any bleeding, such as from your nose or gums or in your urine
• Skin rash
• Moderate to severe mouth sores or blistering