Chlorambucil, Oral

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KEY POINTS

• This medicine is taken by mouth to treat certain kinds of cancers. Take it exactly as directed.
• This medicine may increase the risk of some cancers. It may also make you sterile (unable to have children).
• You may get infections more easily when you are taking this medicine.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: chlorambucil, oral; Leukeran

What is this medicine used for?

This medicine is taken by mouth to treat certain types of leukemia, certain cancerous tumors, lymphomas, and Hodgkin's disease. It does not cure these diseases but can reduce their effects on your body.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A head injury or brain tumor
• Liver disease
• Seizures

Also, tell your healthcare provider if you have recently had any kind of infection or if you are receiving radiation therapy.

This medicine may make you sterile (unable to have children) whether you are a man or a woman. If you plan to have children someday, talk with your healthcare provider before you start treatment.

Females of childbearing age: Do not take this medicine during pregnancy because it can harm the baby. Do not become pregnant while you are taking this medicine. Talk to your healthcare provider if you need birth control. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Take it 1 hour before or 2 hours after meals. Taking this medicine at bedtime may help to lessen stomach upset.

Check with your healthcare provider before using this medicine on children under age 18.

Alcohol, acidic, spicy, or hot foods may increase stomach irritation from the medicine. Ask your healthcare provider about your diet and how much water you should drink while taking this medicine. You need to drink at least 8 full glasses of liquid a day.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and use the next one as directed. Do not use double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: restlessness, loss of balance, vomiting, blood in urine, trouble breathing, coma, seizures.

What should I watch out for?

This medicine may increase the risk of certain cancers. Talk with your healthcare provider about this.

Your healthcare provider will want to examine you regularly to monitor your progress. You need frequent blood tests to avoid serious side effects and to find out if you need a change in dosage. Keep all your appointments and follow dosage instructions exactly. If you have any questions about this medicine, ask your healthcare provider or pharmacist to explain.

You may get serious infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Contact your healthcare provider right away if you develop a fever or ANY other symptoms of infection. Also, do not have any vaccines without getting your healthcare provider's approval first.

While taking this medicine, you may bleed more easily and it may take longer for you to stop bleeding. Avoid activities where you could be bruised, cut, or injured. Report any unusual bruising or bleeding to your healthcare provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding, unusual tiredness or weakness, fever, yellowing of your skin or eyes, cough, sore throat, trouble breathing, delayed or no menstruation, severe nausea, vomiting, severe diarrhea, seizures, unusual lumps or swelling, dark urine, light-colored bowel movements, numbness in your hands or feet, muscle twitching, confusion, hallucinations, unusual mood or behavior changes, trouble walking, vision loss, mouth sores, severe skin redness or rash, skin blisters or peeling.

Other: Diarrhea, mild nausea, weakness or shakiness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Clozapine (Clozaril, FazaClo)
• Denosumab (Prolia, Xgeva)
• Echinacea
• Immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Leflunomide (Arava)
• Natalizumab (Tysabri)
• Roflumilast (Daliresp)
• Trastuzumab (Herceptin)
• Vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine in the refrigerator. Keep the container tightly closed. Do not freeze. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.