Chlorambucil

Also known as: Chloraminophene

Drug #157

Chlorambucil is an alkylating agent of nitrogen mustard group, also known as anti-cancerous drug. All alkylating agents have or can form an alkyl group that becomes covalently bound to cellular constituents. Chlorambucil is effective in the treatment of different cancers such as chronic lymphocytic leukemia, multiple myeloma, and lymphosarcoma. Aministered orally. Chlorambucil is used in combination with other anticancerous drugs to obtain best therapeutic effects and to minimize side effects or toxicities.

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Primary Characteristics

Chlorambucil is also known as Chloraminophene.

It is of Synthetic origin and belongs to Alanine mustard.

It belongs to Alkylating Agents pharmacological group on the basis of mechanism of action and also classified in Antineoplastic Agent, Alkylating Agent pharmacological group.

Molecular Weight: 304.2 · pK_a: 5.8 · Solubility in Water: < 1 in 10000 · Solubility in Alcohol: 1 in 1.5 · Non-proprietary name: Chlorambucil.

Pharmacokinetics

Absorption: Chlorambucil has an oral bioavailability is 87% (±20%).

Distribution: Chlorambucil has a volume of distribution is 0.29l/kg. plasma protein binding is 99%.

Elimination: it is metabolised via renal & hepatic, plasma half-life is 1-2 hr, renal excretion is <1.

Indications

Chlorambucil is primarily indicated in conditions like Breast cancer, Chronic lymphocytic leukaemia, Hodgkin's disease, Leukaemia, Macroglobulinemia, Non-hodgkin's lymphoma, Non-hodgkin's lymphoma, Ovarian cancer, Waldenstrom's macroglobulinaemia.

Contraindications

Chlorambucil is contraindicated in conditions like Thrombocytopenia, Leukopenia.

Dosage

Chlorambucil's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
150 ug/kg	150 ug/kg	Every 24h	PO	For 3-8 Weeks, As Required
Paediatric Dosage (20kg)
0.15 mg/kg	0.15 mg/kg	Every 24h	Oral	-
Neonatal Dosage (3kg)
0 – 0	—	—		No indication for use in neonates

Drug Interactions

Unknown2 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Chlorambucil in overdosage may give rise to further complications which include Hepatotoxicity , Marrow failure , Amenorrhea, Azoospermia , Hepatotoxicity , Ovarian function suppression.

Chlorambucil produces potentially life-threatening effects which include Bone marrow suppression, Neutropenia , Interstitial pulmonary fibrosis, Chromosome damage, Lymphocytopenia. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Chlorambucil are Neurotoxicity, Ataxia, Grand Mal Seizures (epilepsy), Irreversible marrow failure, Agitation.

Chlorambucil is known to cause more or less tolerable side effects which are usually transient. These include Abdominal discomfort, Cystitis, Diarrhea, Hypersensitivity reactions, Nausea, Oral ulceration, Skin rash, Stevens Johnson syndrome, Vomiting .

Warnings / Precautions

Chlorambucil can lower body ability to fight an infection, consult the doctor if any signs of an infection such as fever, sore throat, rash or chills appear. It should be used with caution in patients with gout, kidney stones or history of seizure or head injury. Do not have immunizations or vaccinations without consent of doctor and avoid contact with people who have recently received oral polio vaccine. This medication is not recommended for use in pregnant or nursing women There is leucopenia or thrombocytopenia due to marrow infilteration of secondary to previous cytotoxic chemotherapy.Treatment with this any may couse furthure supperssion .So, should be given with caution after radiotherapy.

Available Brands

None recorded.

Storage Conditions

Chlorambucil should be stored Tab.

Drug Classification

1.8.2 — Cytotoxic (anti-neoplastic) drugs