Chlorambucil

Brand names

• Alti-Chlorambucil
• Leukeran

Usage

To treat some types of cancer, especially leukemia and lymphoma (cancer of the lymphatic system). More specifically, chlorambucil is used to treat chronic lymphocytic leukemia (a type of leukemia caused by overproduction and abnormal formation of certain white blood cells important in the body's immune system) and Hodgkin's disease (a type of cancer affecting the lymphatic system, characterized by painless swelling of the lymph nodes).

How it works

Chlorambucil kills cancer cells by interfering with the activity of their genetic material, thus preventing the cells from reproducing. The medicament may also affect the growth and development of normal cells in the body, resulting in unpleasant side effects.

Side effects

Serious

Black or tarry stools; blood-tinged (pink or maroon) urine or stools; cough or hoarseness; fever; chills; lower back pain or pain in flanks; painful, difficult urination; small, red spots on the skin; bleeding from gums, nose, or other unusual places; easy bruising; shortness of breath. These side effects may mean that normal blood cells and special blood-clotting cells have been affected, or that normal immune cells have been affected and an infection is developing somewhere in your body. Severe rash. Seek medical help right away if any of these occur.

Common

Nausea and vomiting.

Less common

Painful joints, rash, itching, swelling of feet or lower legs (edema), changes in menstruation, diarrhea.

Possible interactions

Other medicaments:

Chlorambucil taken concurrently with:

• amphotericin B (Abelcet) may increase risk of bronchial spasm, low blood pressure and kidney (nephrotoxicity) toxicity.
• antidepressant or antipsychotic (neuroleptic) medicaments requires careful monitoring; these medicaments lower the seizure threshold and increase the risk of chlorambucil-induced seizures.
• aspirin may increase the risk of bruising or bleeding; the platelet-reduction effects of chlorambucil and the antiplatelet action of aspirin are additive.
  Avoid aspirin while taking chlorambucil.
• other immunosuppressant medicaments can increase the risk of infection and the development of secondary cancers.
• tramadol (Ultram) may increase risk of seizures.
• live virus vaccines (such as rotavirus vaccine) may result in overwhelming infections.

Herbal medicines or minerals:

Echinacea: some patients use Echinacea to attempt to boost their immune systems. Unfortunately, use of Echinacea is not recommended in people with damaged immune systems. This herb may also actually weaken any immune system if it is used too often or for too long a time.

Alcohol:

Avoid if platelet counts are low and there is a risk of stomach bleeding.

Marijuana smoking:

Increases risk of central nervous system toxicity. Some fungal infections (toxoplasmosis) may be contracted from marijuana itself if the immune system is weak.

Discontinuation:

Many factors will determine when and how this medicament should be stopped. Follow your doctor's advice to get the best results.

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