Chlorambucil
Mechanism :
Chlorambucil is a bifunctional alkylating agent of the nitrogen mustard type that has been found active against selected human neoplastic diseases.
Indication :
- Hodgkin disease
- Non-Hodgkin lymphoma
- Amyloidosis
- Juvenile idiopathic arthritis
Contraindications :
Chlorambucil should not be used in patients whose disease has demonstrated a prior resistance to the agent. Patients who have demonstrated hypersensitivity to chlorambucil should not be given the drug. There may be cross-hypersensitivity (skin rash) between chlorambucil and other alkylating agents.
Dosing :
0.1-0.2 mg/kg (Oral) daily.
(Safety and efficacy not established, but used off-label).
Adverse Effect :
Bone marrow suppression, nausea and vomiting, diarrhea, oral ulceration, tremors, muscular twitching, confusion, agitation, ataxia, flaccid paresis, hallucinations, urticaria, angioneurotic edema, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, pulmonary fibrosis, hepatotoxicity, jaundice, drug fever, peripheral neuropathy, interstitial pneumonia, sterile cystitis, infertility, leukemia, and secondary malignancies.
Interaction :
There are no known drug interactions with chlorambucil.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
Chlorambucil is metabolized in the liver. Consider an initial dose reduction.