Dangerous Drug: Chlorambucil(klor am’ byoo sil)
Leukeran
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Nitrogen mustard derivative
Therapeutic Actions
Cytotoxic: Alkylates cellular DNA, interfering with the replication of susceptible cells.
Indications
Palliative treatment of chronic lymphocytic leukemia; malignant lymphomas, including lymphosarcoma; giant follicular lymphoma; and Hodgkin lymphoma
Unlabeled uses: Ovarian and testicular carcinomas, Waldenström macroglobulinemia, non-Hodgkin lymphoma, polycythemia vera
Contraindications and Cautions
Contraindicated with allergy to chlorambucil; cross-sensitization with melphalan, pregnancy.
Use cautiously with radiation therapy, chemotherapy, myelosuppression, lactation.
Available Forms
Tablets—2 mg
Dosages
Individualize dosage based on hematologic profile and response.
Adults
Initial dose and short-course therapy: 0.1–0.2 mg/kg per day PO for 3–6 wk; single daily dose may be given.
Chronic lymphocytic leukemia (alternate regimen): 0.4 mg/kg PO every 2 wk, increasing by 0.1 mg/kg with each dose until therapeutic or toxic effect occurs.
Maintenance dose: 0.03–0.1 mg/kg/day PO. Do not exceed 0.1 mg/kg/day. Short courses of therapy are safer than continuous maintenance therapy; base dosage and duration on patient response and bone marrow status.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
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