Chlorambucil (Generic Name)

Other Names: Leukeran®

About This Drug

Chlorambucil is used to treat cancer. It is taken by mouth.

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.

Possible Side Effects (Less Common)

  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
  • Loose bowel movements (diarrhea) that may last for a few days
  • Rash: A rash that looks like acne may happen on your face and upper back when taking this medicine. Your doctor can give you medicine to help treat this.
  • Decreased appetite (decreased hunger)
  • Soreness of the mouth and throat (rare). You may have red areas, white patches, or sores that hurt.
  • Hair loss (rare). Most often hair loss is temporary; your hair should grow back when treatment is done.
  • Changes in your central nervous system can happen (rarely). The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.
  • Effects on the bladder (rare). These may include:
  • Trouble passing urine or pain with urination
  • The need to urinate frequently, often passing only small amounts of urine
  • An urgent need to urinate
  • Blood in the urine
  • Changes in lung tissue may occur with large amounts of this drug. These changes may not last forever, and your lung tissue may go back to normal. Sometimes these changes may not be seen for many years. You may get a cough or have trouble catching your breath.
  • Changes in your liver function. Your doctor will check your liver function as needed.

Treating Side Effects

  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Ask your doctor or nurse about medicine that is available to help stop or lessen the loose bowel movements.
  • Talk with your nurse about getting a wig before you lose your hair. Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • If you get a rash do not put anything onit unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine ifthe rash bothers you.

Important Information

  • Swallow the medicine whole. Do not chew, break or crush it.
  • If you miss a dose, take it as soon as you remember. Do not take it if it is close (within 12 hours) of your next dose. Just take the next dose at your normal time. Do not take more than 1 dose at a time.

Food and Drug Interactions

There are no known interactions of chlorambucil with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurseright awayif you have any of these symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Wheezing or trouble breathing
  • Easy bruising or bleeding
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Feeling dizzy or lightheaded
  • Seizures
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or week, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Difficult or painful urination
  • Increase in the number of times you urinate, often passing only small amounts of urine
  • Blood in the urine
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Pain in your arms or legs not relieved by prescribed medicines
  • Headache that does not go away
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Muscle weakness
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities

Sexual Problems and Reproductive Concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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