Chlorambucil is an anticancer drug that belongs to the class of medications called alkylating agents. FDA approved it initially on November 1, 2013, for treating some types of cancer and certain blood problems.

Chlorambucil is available as a tablet. It is used to treat Hodgkin’s disease and non-hodgkin’s lymphoma (cancers formed from cells of the lymphatic system). It is also indicated to treat chronic lymphocytic leukemia (A type of WBC cancer, where the bone marrow produces a large number of abnormal cells) and Waldenstrom’s macroglobulinemia (A rare lymphoma associated with an uncontrolled increase of B-cells, a type of white blood cell, resulting in the release of an abnormal protein into the blood.)

Chlorambucil is available as an oral prescription drug. It is available in two doses 200mg and 400mg. Your doctor will decide the dose, and duration of the therapy based on your disease status, severity, and other factors such as body weight, other disease conditions, and age. Always take this medicine as prescribed by your doctor. Take the tablet daily on an empty stomach at least one hour before meals or three hours after meals. Do not break, chew, crush, or break the tablet. Swallow the whole tablet with water. 

The common side effects include anemia, decreased platelet count, and decreased white blood cells. Other serious side effects include severe skin reactions, liver toxicity, hypersensitivity reaction, seizure, hallucinations, infertility, and lung problems.

This drug is indicated to cause severe bone marrow depression. Report to your physician immediately if you have decreased RBC and WBC levels. Inform the physician about your recent vaccination history, liver problems, kidney problems, and seizures. Chlorambucil can cause fetal harm. Inform your physician if you are pregnant or planning to get pregnant during the treatment. This medicine may cause infertility that is due to ovarian or testicular suppression. 

Inform your physician if you have had radiotherapy or cancer chemotherapy recently or have a kidney problem. Do not take Chlorambucil if you are allergic to chlorambucil or any of the other ingredients. Inform your healthcare provider about all the medicines you take, including prescription medications, over-the-counter medications, nutritional and vitamin supplements, and herbal products. Certain medications interact with chlorambucil and reduce its effectiveness by causing undesirable side effects. Use effective contraception during the treatment. Do not breastfeed during the treatment with this medicine because it may cause harm to the baby.  It is possible that the use of this medicine, particularly in the long term, may increase the risk of developing secondary blood cancer. Your healthcare professional may advise you to take certain blood tests to monitor the effectiveness and side effects of the therapy. 

Store chlorambucil tablets in a refrigerator, 2° to 8°C. Protect the medicine from light and excessive moisture. Keep the medicine out of reach of children and pets. If you forgot to take the tablet, simply take your next dose at the scheduled time. Do not take a double dose to make up for a forgotten dose. This medicine may cause changes in your blood levels. This medicine may you to bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. If you vomit after taking the medicine, do not take an extra dose. Take your next dose at the regular time. Do not stop taking this medicine without talking to your doctor. 

1. Chlorambucil 2mg tablets - Summary of Product Characteristics (SmPC) - (emc). www.medicines.org.uk. [Published January 2017]. [Accessed April 20, 2023.] https://www.medicines.org.uk/emc/product/4656/smpc
2. Edward Chu, Cancer Chemotherapy, Lange’s Basic and Clinical Pharmacology, 14th Edition, 2018, 948-976.
3. Highlights Of Prescribing Information - Chlorambucil. [Revised on 2006] [cited 2023 April 20]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/010669s030lbl.pdf 

The drug information on this page is not a substitute for medical advice. It is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you can receive this treatment.