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Precautions and Warnings With Chlorambucil

People with a history of a head injury, seizures, or other medical problems may not be able to take chlorambucil safely. To help ensure this medicine is appropriate for you, your healthcare provider needs to know if you have any allergies or if you are taking any other medications before starting treatment with chlorambucil. Warnings and precautions also apply to women who are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking chlorambucil (Leukeran®) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Received radiation treatment
  • Received other chemotherapy treatment
  • Low white blood cells
  • Low platelets or anemia
  • A history of seizures
  • Ever had a head injury
  • An infection or get infections easily
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Chlorambucil

Some warnings and precautions to be aware of prior to taking this medication include the following:
  • Chlorambucil can increase your risk for developing other cancers, including leukemia, in the future. People who take large doses or use the medication for extended periods of time likely have a higher risk. You and your healthcare provider should weigh the benefits of chlorambucil treatment with the risk for future cancers.
  • Chlorambucil can cause sterility (complete infertility) in both men and women. This side effect may be irreversible.
  • There have been reports of serious skin rashes, including life-threatening rashes known as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), occurring in people taking this medicine. If you notice any skin rash while taking this medication, contact your healthcare provider right away.
  • Like other chemotherapy medicines, chlorambucil can cause life-threatening bone marrow suppression. As a result, your bone marrow may not produce necessary blood cells, which could cause the following problems:
Your healthcare provider will monitor your blood cell counts regularly during treatment, and may decrease your dosage if your blood cell counts drop too low.
  • Some people who take this medicine may have an increased risk for seizures. This includes children and people receiving high intermittent doses. Your risk may be further increased if you have a history of seizures or a head injury.
  • Chlorambucil is a pregnancy Category D medication, which means it may harm an unborn child if taken during pregnancy (see Leukeran and Pregnancy).
  • It is unknown whether chlorambucil passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Leukeran and Breastfeeding).
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