Chlorambucil is used to treat a number of different cancers of the blood or lymphatic system.
Keep your regular appointments with your doctor or hospital. You will need to have frequent blood tests and check-ups.
The most common side-effects are feeling sick, diarrhoea and mouth ulcers.
|Type of medicine||An alkylating chemotherapy medicine|
|Used for||Treatment of cancer|
Chlorambucil is used to treat some cancers, particularly cancer of white blood cells and cancers of the lymphatic system. It can be prescribed for both adults and children.
In cancer, certain cells in the body grow and multiply too fast. Chemotherapy (anti-cancer) medicines like chlorambucil work by preventing the growth and division of cells, and this reduces the number of cancer cells your body makes. Chlorambucil can be used as a treatment on its own, or alongside other medicines to help treat your condition.
Before taking chlorambucil
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you (or, if appropriate, your child) start taking chlorambucil it is important that your doctor or pharmacist knows:
- If you are pregnant or breast-feeding.
- If you have any problems with the way your liver works.
- If you have a kidney problem called nephrotic syndrome.
- If you have ever had a fit or if you have epilepsy.
- If you have an infection or feel unwell.
- If you have porphyria (this is a rare inherited blood disorder).
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take chlorambucil
- Before you start this treatment, read any printed information you have been given by your doctor and the leaflet from inside your pack of tablets. The leaflet will give you more information about chlorambucil and a full list of side-effects which you may experience from taking it.
- Chlorambucil will be given to you by a specialist doctor who is experienced in treating your condition. Your doctor will calculate what dose is right for you and will tell you how many tablets to take each day - it is important that you take chlorambucil exactly as you have been told. Your dose will also be printed on the label of your pack. If you are unsure about what to do, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
- You should take the tablets when your stomach is empty, which means taking them one hour before eating food, or waiting until three hours afterwards. This is because food prevents chlorambucil from being absorbed by your body, which means the medicine is much less effective for you. Swallow the tablets with a drink of water. Do not break, crush or chew them.
- Try to take chlorambucil at the same time each day, as this will help you to remember to take your doses.
- If you are sick shortly after taking a dose, or if you forget a dose, contact your doctor or clinic for advice on what to do. You will be told whether to take the dose again, or wait until the next dose is due.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests and check-ups during your treatment.
- Chlorambucil lowers the number of white cells in your blood, increasing the chance of you getting an infection. You should take certain precautions to reduce the risk of infection - if possible, avoid people with infections and let your doctor know if you think you are getting a sore throat or if you have a high temperature.
- It is important that you do not get pregnant or father a child while you are taking chlorambucil. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
- While you are taking chlorambucil and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Chlorambucil lowers your body's resistance so there is a chance that you may get an infection from some vaccines.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- If you intend to have children in the future, you should ask your doctor for advice about family planning before you begin taking chlorambucil. This is particularly important if you are a man, as there is a risk of reduced fertility after chlorambucil treatment.
Can chlorambucil cause problems?
Along with their useful effects, most medicines can cause side-effects although not everyone experiences them. Before you start treatment with chlorambucil, your doctor will discuss with you the possibility of unwanted side-effects occurring. The table below contains some of the most common ones. You will find a full list of side-effects in the manufacturer's information leaflet supplied with your tablets.
|Common chlorambucil side-effects - these affect less than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Feeling or being sick||Stick to simple foods. Let your doctor know about this, as an anti-sickness medicine may help|
|Diarrhoea||Drink plenty of water to replace lost fluids. If this continues, speak with your doctor|
|Mouth ulcers||Brushing your teeth 2-3 times a day with a soft toothbrush and regularly using a mouth rinse may help to prevent this. If mouth ulcers become a problem, speak with your doctor|
|Less common but more serious chlorambucil side-effects||What can I do if I experience this?|
|A high temperature, or symptoms of an infection||Let your doctor know about this straightaway|
|Skin rash||Let your doctor know about this as soon as possible. Some skin rashes can be a sign of an allergic-type reaction|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store chlorambucil
- Keep all medicines out of the reach and sight of children.
- Store the tablets in a refrigerator.
- Return any unused or unwanted tablets to your pharmacy to destroy. They will need special disposal.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Chlorambucil 2 mg tablets; Aspen, The electronic Medicines Compendium. Dated November 2012.
- British National Formulary; 65th Edition (Mar 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall