Chlorambucil

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Drug-interactions 7 Mechanism-of-action 8 Patient-information 9 More General Terms 10 Internet Database 11 References

Introduction

• Tradename: Leukeran.

Indications

• chronic lymphocytic leukemia

• induction 0.1-0.2 mg/kg/day for 3 weeks
• 0.4 mg/kg every 2-4 weeks

• Hodgkin's disease
• non-Hodgkin's lymphoma

• 16 mg/m2/day for 5 days every 4 weeks

• macroglobulinemia
• polycythemia vera
• trophoblastic neoplasms
• ovarian neoplasms
• nephrotic syndrome unresponsive to conventional therapy

Dosage

• Tabs: 2 mg

Pharmacokinetics

• well absorbed orally
• food slows absorption
• metabolized by liver
• 1/2life 1-2 hours
  

• elimination via liver
• 1/2life = 1-2 hours

Adverse-effects

• common (> 10%)

• myelosuppression

• onset 7 days
• nadir 10-14 days
• recovery 28 days

• increased incidence of secondary malignancy, especially, acute myelogenous leukemia ( AML)

• less common (1-10%)

• menstrual changes, skin rashes, hyperuricemia, diarrhea, oral ulceration, nausea/vomiting

• uncommon (< 1%)

• drug fever, hepatic necrosis, weakness, rash, leukopenia, thrombocytopenia, tremors, twitching, confusion, agitation, ataxia, hallucinations, seizures, peripheral neuropathy, fertility impairment ( oligospermia, amenorrhea) pulmonary fibrosis (cumulative effect), keratitis, hepatotoxicity, skin hypersensitivity
  
• drug adverse effects of alkylating agents

Drug-interactions

• barbiturates may increase the toxicity of chlorambucil

Mechanism-of-action

• alkylating agent

Patient-information

• contraception indicated during therapy
• notify physician if bleeding or sore throat occurs

More General Terms

• alkylating agent
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 2708
PubChem: 13936
PubChem: 83907

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998

chlorambucil (Leukeran)