Chlorambucil (Systemic)

Brand Names : Leukeran

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For chlorambucil, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to chlorambucil or other cancer medicines.

Pregnancy - This medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. In addition, many cancer medicines may cause sterility which could be permanent. Sterility has been reported with this medicine and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are taking chlorambucil. Tell your doctor right away if you think you have become pregnant while taking chlorambucil.

Breast-feeding - Because chlorambucil may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Children - In general, this medicine has not been shown to cause different side effects or problems in children than it does in adults. However, some children with nephrotic syndrome (a kidney disease) may be more likely to have convulsions (seizures).

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of chlorambucil in the elderly with use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking chlorambucil it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines - Chlorambucil may increase the effects of these medicines or radiation therapy on the blood

• Azathioprine (e.g., Imuran) or
• Corticosteroids (cortisone-like medicine) or
• Cyclophosphamide (e.g., Cytoxan) or
• Cyclosporine (e.g., Sandimmune) or
• Cytarabine (e.g., Cytosar-U) or
• Mercaptopurine (e.g., Purinethol) or
• Muromonab-CD3 (monoclonal antibody) (e.g., Orthoclone OKT3) or
• Tacrolimus (e.g., Prograf) - There may be an increased risk of infection and development of cancer because chlorambucil decreases the body's ability to fight them

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) - Chlorambucil may increase the amount of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not work as well in patients taking chlorambucil

Other medical problems - The presence of other medical problems may affect the use of chlorambucil. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• Convulsions (seizures) (history of) or
• Head injury - Increased risk of seizures

• Gout or
• Kidney stones (history of) - Chlorambucil may increase levels of uric acid in the body, which can cause gout or kidney stones

• Bone marrow depression or
• Infection - Chlorambucil decreases your body's ability to fight infection
• Previous failure of chlorambucil therapy - Repeat treatment with chlorambucil not recommended