Chlorambucil Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Chlorambucil Tablet (generic name: Chlorambucil) is an alkylating agent used as an anti-cancer chemotherapy drug for Hodgkin's disease and specific types of leukemias and lymphomas. It is swallowed with a glass of water and works by slowing down or stopping the growth of cancer cells. It is not curative but may produce useful palliation of symptoms.

What is Chlorambucil Tablet

Chlorambucil is an anti-cancer chemotherapy drug used for treatment of Hodgkin's disease and specific types of leukemias and lymphomas. It is a tablet that you swallow with a glass of water.

Chlorambucil Tablet uses

• Chronic lymphatic (lymphocytic) leukemia (CLL)
• Malignant lymphomas including lymphosarcoma
• Giant follicular lymphoma
• Hodgkin's disease
• Non-Hodgkin's lymphoma (NHL)

Benefits of Chlorambucil Tablet

• It is not curative in any of these disorders but may produce clinically useful palliation.
• It does not cure these conditions but may help with symptoms that you may have.
• Treats certain chronic lymphocytic leukemias
• Used in selected lymphomas
• Damages DNA in rapidly dividing malignant cells
• Can reduce abnormal lymphocyte burden
• Provides an oral chemotherapy option

How Chlorambucil Tablet works

Chlorambucil belongs to a group of medicines called alkylating agents. It works by slowing down or stopping the growth of cancer cells.

Chlorambucil Tablet dosage

Take this medicine by mouth, usually once a day, for a course of 3 to 6 weeks as directed by your doctor. Some treatment plans use it differently, giving a single dose every 2 weeks or once a month instead of daily. Take it at around the same time every day.

Follow your prescription label and your doctor's instructions exactly. Do not take more or less than prescribed, and do not take it more often. Do not stop taking it without talking to your doctor first.

Unless your doctor tells you otherwise, you can continue your normal diet while taking this medicine. Your doctor may change your dose based on how you respond to treatment and any side effects you have.

Available forms and strengths

• Tablet

Side effects of Chlorambucil Tablet

Common

• Nausea
• Vomiting
• Diarrhea
• Sores in the mouth and throat (oral ulceration)
• Tiredness
• Missed menstrual periods in women
• White patches or sores in or around your mouth

Serious

• Skin rash, including severe skin reactions with blistering and peeling
• Unusual bruising or bleeding
• Black, tarry stools
• Red or dark colored urine
• Cough, sore throat, congestion, fever, or difficulty breathing (signs of infection)
• Seizures
• Yellowing of the skin or eyes
• Pain in the upper right part of the stomach
• Frequent urination
• Unusual lumps or masses
• Signs of low blood cell counts such as high body temperature, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, or feeling light-headed or short of breath
• Signs of an allergic reaction such as difficulty breathing, swelling in your face or throat, or hives

Warnings and precautions

• Do not take chlorambucil if you are pregnant or planning to become pregnant, as it can harm the unborn baby or cause birth defects. Use effective birth control during treatment and for some time afterward.
• It is not known if this medicine passes into breast milk, but because of the risk of serious side effects to a nursing infant, you and your doctor should decide whether to stop breastfeeding or stop the medicine.
• Tell your doctor if you have kidney disease before starting this medicine.
• Tell your doctor if you have liver disease before starting this medicine.
• Discuss alcohol use with the oncology team, especially if liver function is abnormal.
• Fatigue, dizziness, or weakness may make driving unsafe.
• This medicine can severely suppress bone marrow function and is a known human carcinogen. It is likely to cause genetic mutations and birth defects, and it can cause infertility.
• This medicine can lower blood cell counts made in the bone marrow. Your doctor will order regular blood tests before, during, and after treatment to check for this.
• This medicine may increase your risk of developing other cancers later on.
• This medicine can affect menstrual periods in women and stop sperm production in men, and may cause permanent infertility. Even so, do not assume you cannot get pregnant or get someone pregnant — use reliable birth control.
• Do not receive any vaccinations, especially live vaccines, while on this medicine without checking with your doctor first.
• This medicine should be used with extra caution if given within 4 weeks of a full course of radiation therapy or chemotherapy, because the bone marrow is more vulnerable to damage during this time.
• People with a history of seizures or head injury may have a higher risk of seizures with this medicine.

Storage

• Store in a refrigerator, 2° to 8°C (36° to 46°F).
• Keep this medication in the container it came in, tightly closed, and out of reach of children.
• Place the medication in a safe location – one that is up and away and out of sight and reach of children.
• Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program.

When to see a doctor

Get emergency medical help right away if you have signs of an allergic reaction (difficulty breathing, swelling of the face or throat, hives) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple rash with blistering and peeling).

Call your doctor right away if you have a seizure, any unusual lump or mass, severe diarrhea or vomiting, or a cough that is new or getting worse.

Call your doctor right away if you notice signs of bone marrow problems such as dizziness, feeling very tired or short of breath, pale lips or nail beds, or a fast heart rate.

Call your doctor right away if you have signs of liver problems such as poor appetite, pain in the upper right side of your stomach, dark urine, pale stools, or yellowing of the skin or eyes.

Call your doctor right away if you have signs of low blood cell counts, such as high body temperature, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, or feeling light-headed or short of breath.

If you think you have taken too much of this medicine, get emergency medical attention or contact your local poison control center right away. Overdose symptoms may include agitation, fast heartbeats, skin rash, bruising, bleeding gums, nosebleeds, trouble breathing, or signs of infection like fever and chills.

Alternatives

• Bendamustine
• Cyclophosphamide
• Rituximab