CHLORAMBUCIL

Alkylating agent. Cytotoxic anticancer medicine

Dosage Forms

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Tablet

2 mg

Uses

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  • Non-Hodgkin’s lymphomas
  • Hodgkin’s disease
  • Chronic lymphocytic leukaemia

Dose and Duration

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Hodgkin’s disease
Adult and child: as a single agent: usually 0.2 mg/kg/day for 4‒8 weeks
Non-Hodgkin’s lymphoma
Adult and child:Initially, 0.1‒0.2 mg/kg/day for 4‒8 weeks. Maintenance therapy is then given by a reduced daily dosage or intermittent courses of treatment.
Chronic lymphocytic leukaemia
Adult and child: Initially, 0.15 mg/kg/day until the to tal leukocyte count has fallen to 10,000 per µL. Treatment may be resumed 4 weeks after the end of the first course and continued at a dosage of 0.1 mg/kg/day.

Contraindications

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  • Hypersensitivity to chlorambucil
  • Patients who have just recently undergone radiotherapy or received other cytotoxic agents

Side Effects

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  • Rash
  • Blood disorders
  • Stevens-Johnson Syndrome
  • Secondary haematologic malignancies e.g. (especially leukaemia and myelodysplastic syndrome on long-term use)
  • Seizures in children with nephrotic syndrome
  • Nausea, vomiting, diarrhoea, abdominal pain

Interactions

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  • Live vaccines (risk of systemic disease)

Patient Instructions

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  • Take on an empty stomach (at least 1 hour before or 3 hours after food)
  • Report immediately any rash

Pregnancy

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  • Do not use

Breastfeeding

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  • Do not use

Storage

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  • Store between 2‒8°C

⚠️ Caution

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  • Men and women taking chlorambucil should use adequate contraception
  • Monitor blood counts closely
  • Withdraw medicine immediately if a rash develops
  • Use with caution in children with a history of seizures and nephrotic syndrome (increased risk of seizures)
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines