Chlorambucil interactions

Conditions

Conditions in which Chlorambucil needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Chlorambucil can severely suppress bone marrow function. It induces a slowly progressive lymphopenia and dose-related neutropenia. Thrombocytopenia and anemia may also occur. Irreversible bone marrow suppression has been reported and is associated with a total dose of or > 6.5 mg/kg in one course of continuous dosing. Therapy with chlorambucil should be administered cautiously and at a reduced dosage in patients whose bone marrow reserve may be depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

  1 source

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.

• Infections

  Major

  Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

  39 sources

  1. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  2. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories (2002):
  3. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb (2001):
  4. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):
  5. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation (2001):
  6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb (2001):
  7. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb (2001):
  8. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2001):

  Show all 39 sourcesShow fewer sources

  9. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  10. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  11. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  12. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  13. "Product Information. Fludara (fludarabine)." Berlex Laboratories (2001):
  14. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn (2001):
  15. "Product Information. Matulane (procarbazine)." Roche Laboratories (2001):
  16. "Product Information. DTIC-Dome (dacarbazine)." Bayer (2001):
  17. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
  18. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc (2001):
  19. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company (2001):
  20. "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
  21. "Product Information. Taxotere (docetaxel)." Rhone Poulenc Rorer (2001):
  22. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb (2001):
  23. "Product Information. Nipent (pentostatin)." Hospira Inc (2001):
  24. "Product Information. Tabloid (thioguanine)." Prasco Laboratories (2001):
  25. "Product Information. Xeloda (capecitabine)." Roche Laboratories (2001):
  26. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):
  27. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome (2001):
  28. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  29. "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
  30. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn (2001):
  31. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation (2001):
  32. "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):
  33. "Product Information. Halaven (eribulin)." Eisai Inc (2010):
  34. "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc (2014):
  35. "Product Information. Blincyto (blinatumomab)." Amgen USA (2014):
  36. "Product Information. Opdivo (nivolumab)." Bristol-Myers Squibb (2014):
  37. "Product Information. Unituxin (dinutuximab)." United Therapeutics Corporation (2015):
  38. "Product Information. Empliciti (elotuzumab)." Bristol-Myers Squibb (2015):
  39. "Product Information. Pepaxto (melphalan flufenamide)." Oncopeptides Inc. (2021):

• Hepatic Insufficiency

  Moderate

  No formal studies have been conducted in patients with hepatic impairment. As chlorambucil is primarily metabolized in the liver, patients with hepatic impairment should be closely monitored for toxicity. A dose reduction may be considered in patients with hepatic impairment when treated with chlorambucil.

  1 source

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.

• Lung Diseases

  Moderate

  Interstitial pneumonitis and/or fibrosis have been reported during chlorambucil therapy. Pulmonary complications may not be reversible in all patients. Patients should be instructed to immediately report signs and symptoms of pulmonary dysfunction such as cough, dyspnea or congestion. Therapy with chlorambucil should be administered cautiously in patients with or predisposed to pulmonary dysfunction.

  1 source

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.

• Seizures

  Moderate

  An increased risk of seizures has been reported in patients administered high pulse doses of chlorambucil and in children with nephrotic syndromes. Focal and/or generalized seizures have been reported rarely at daily therapeutic doses. Therapy with chlorambucil should be administered cautiously in patients with a history of seizure disorders or head trauma.

  1 source

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.