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Leukeran (chlorambucil) Disease Interactions

There are 5 disease interactions with Leukeran (chlorambucil):

Major

Antineoplastics (applies to Leukeran) infections

Major Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  7. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  8. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  14. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  16. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  17. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  19. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  24. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  25. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  27. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  30. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  31. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
View all 31 references
Major

Chlorambucil (applies to Leukeran) myelosuppression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Bleeding, Bone Marrow Depression/Low Blood Counts, Fever

Chlorambucil can severely suppress bone marrow function. It induces a slowly progressive lymphopenia and dose-related neutropenia. Thrombocytopenia and anemia may also occur. Irreversible bone marrow suppression has been reported and is associated with a total dose of or > 6.5 mg/kg in one course of continuous dosing. Therapy with chlorambucil should be administered cautiously and at a reduced dosage in patients whose bone marrow reserve may be depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
Moderate

Chlorambucil (applies to Leukeran) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

No formal studies have been conducted in patients with hepatic impairment. As chlorambucil is primarily metabolized in the liver, patients with hepatic impairment should be closely monitored for toxicity. A dose reduction may be considered in patients with hepatic impairment when treated with chlorambucil.

Moderate

Chlorambucil (applies to Leukeran) pneumonitis/fibrosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

Interstitial pneumonitis and/or fibrosis have been reported during chlorambucil therapy. Pulmonary complications may not be reversible in all patients. Patients should be instructed to immediately report signs and symptoms of pulmonary dysfunction such as cough, dyspnea or congestion. Therapy with chlorambucil should be administered cautiously in patients with or predisposed to pulmonary dysfunction.

References

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
Moderate

Chlorambucil (applies to Leukeran) seizures

Moderate Potential Hazard, Low plausibility.

An increased risk of seizures has been reported in patients administered high pulse doses of chlorambucil and in children with nephrotic syndromes. Focal and/or generalized seizures have been reported rarely at daily therapeutic doses. Therapy with chlorambucil should be administered cautiously in patients with a history of seizure disorders or head trauma.

References

  1. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.

Leukeran (chlorambucil) drug interactions

There are 198 drug interactions with Leukeran (chlorambucil)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.