৳ 45.48/unit
Pack: ৳ 1,137
৳ 45.48/unit
Pack: ৳ 1,137
At a glance
Chlorambucil is an anti-cancer medication used in the treatment of some cancers of the blood and lymphatic system.
Indications
- Hodgkin's Disease
- Non-Hodgkin's Lymphoma
- Chronic Lymphocytic Leukemia
- Waldenstrom's Macroglobulinemia
- Blood cancer
Pharmacology
Chlorambucil produces its anti-cancer effects by interfering with DNA replication and damaging the DNA in a cell. The DNA damage induces cell cycle arrest and cellular apoptosis via the accumulation of cytosolic p53 and subsequent activation of Bax, an apoptosis promoter.
Chlorambucil alkylates and cross-links DNA during all phases of the cell cycle, inducing DNA damage via three different methods of covalent adduct generation with double-helical DNA: attachment of alkyl groups to DNA bases, DNA damage via the formation of cross-links, and induction of mispairing of the nucleotides leading to mutations.
Dosage
Adult Dose:
| Indication | Dose | Schedule |
|---|---|---|
| Chronic Lymphocytic Leukemia | 0.1 mg/kg/day | 3-6 weeks |
| Hodgkin's Lymphoma | 0.2 mg/kg/day | 3-6 weeks |
| Hodgkin's Disease | 200 mcg/kg/day | 4-8 weeks |
| Non-Hodgkin's Lymphoma | 100-200 mcg/kg/day | 4-8 weeks |
| Waldenstrom's Macroglobulinemia | Initial: 6-12 mg/day; Maintenance: 2-8 mg/day | — |
Hepatic Impairment: Primarily metabolized in liver; dose reduction may be required.
Renal Impairment: <1% (including metabolites) excreted in urine; no dose adjustment required.
Side effects
Common Side Effects:
- Anemia (low red blood cell count)
- Decreased blood cells (red cells, white cells, and platelets)
- Decreased white blood cell count (neutrophils)
- Bone marrow suppression
- Nausea
- Vomiting
- Diarrhea
- Mouth ulcer
Rare: Irreversible bone marrow failure, allergic reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures, movement disorders, interstitial pulmonary fibrosis, interstitial pneumonia, hepatotoxicity, jaundice, sterile cystitis, drug fever.
Use in pregnancy
[CONSULT YOUR DOCTOR] Chlorambucil may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor. Pregnancy Category D.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
- [CONSULT YOUR DOCTOR] It is not known whether Chlorambucil alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react.
- Chlorambucil should be taken one hour before a meal or two hours after a meal.
- Monitor FBC closely. Bone marrow suppression is reversible only if withdrawn early enough.
- Should not be given to patients who have recently undergone radio- or chemotherapy.
- In lymphocytic infiltration of bone marrow or hypoplastic bone marrow, max daily dose is 0.1 mg/kg.
- Children with nephrotic syndrome, patients on high pulse dosing regimens, history of seizure disorders require caution.
- Ensure adequate contraceptive precautions.
Overdose effects
Chlorambucil overdose may cause bone marrow suppression, seizures, nausea, vomiting, diarrhea, and gastrointestinal ulceration. In case of overdose, symptomatic and supportive treatment should be given.
Storage conditions
Store in a cool and dry place, protected from light. Keep out of reach of children.