Chlorambucil Side Effects

Some side effects of chlorambucil may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to chlorambucil: oral tablet

Get emergency medical help if you have any of these signs of an allergic reaction while taking chlorambucil: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking chlorambucil and call your doctor at once if you have:

• fever, chills, body aches, flu symptoms, sores in your mouth and throat, ongoing cough;

• pale skin, easy bruising, unusual bleeding, blood in your urine or stools;

• feeling weak or tired, loss of appetite, rapid weight loss;

• nausea, upper stomach pain, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• an unusual mass or lump;

• chest discomfort, feeling short of breath on exertion, dry cough or hack;

• severe vomiting or diarrhea;

• seizure (convulsions); or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• mild nausea or diarrhea;

• tremors or shaking; or

• numbness, burning pain, or tingly feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to chlorambucil: compounding powder, oral tablet

Hematologic

Bone marrow suppression has been reported to usually be reversible if chlorambucil is withdrawn early enough. However, irreversible bone marrow failure has been reported.

Hematologic side effects including bone marrow suppression have been the most commonly reported with the use of chlorambucil. Anemia, leukopenia, neutropenia, thrombocytopenia, and pancytopenia have also been reported.

Nervous system

Most nervous system effects have been reported to resolve upon discontinuation of the drug.

The manufacturer has noted that children with nephrotic syndrome and patients receiving high pulse doses of chlorambucil may have an increased risk of seizures.

Nervous system side effects including coma, tremors, muscular twitching, confusion, agitation, ataxia, flaccid paresis, hallucinations, and focal and/or generalized seizures have been reported rarely. Peripheral neuropathy has also been reported.

Dermatologic

Dermatologic side effects have included skin hypersensitivity with rare reports of skin rash progressing to erythema multiforme, toxic epidermal necrolysis, and Stevens-Johnson syndrome.

Gastrointestinal

Gastrointestinal side effects including nausea, vomiting, diarrhea, and oral ulceration have been reported infrequently. Jaundice has also been reported.

Respiratory

Respiratory side effects including pulmonary fibrosis and interstitial pneumonia have been reported.

Hepatic

Hepatic side effects including hepatotoxicity have been reported. A case of chlorambucil-induced acute hepatic failure has been reported in a patient with membranous nephropathy.

Genitourinary

Genitourinary side effects including sterile cystitis and infertility have been reported.

Oncologic

Oncologic side effects including leukemia and secondary malignancies have been reported.

General

General side effects including drug fever have been reported.

Ocular

Ocular side effects including one case of visual failure and optic atrophy have been reported.

Psychiatric

Psychiatric side effects including lethargy and stupor have been reported.

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