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Chlorambucil Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jun 21, 2022.

For the Consumer

Applies to chlorambucil: oral tablets


  • May severely suppress bone marrow function.107 (See Hematologic Effects under Cautions.)

  • Known carcinogen.107 (See Carcinogenicity under Cautions.)

  • May cause fetal harm.107 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

  • May cause male or female infertility.107 (See Fertility under Cautions.)

Side effects include:

Bone marrow suppression.

For Healthcare Professionals

Applies to chlorambucil: compounding powder, oral tablet


Very common (10% or more): Leukopenia, neutropenia, thrombocytopenia, pancytopenia, bone marrow suppression

Common (1% to 10%): Anemia

Very rare (less than 0.01%): Irreversible bone marrow failure[Ref]

Nervous system

Common (1% to 10%): Convulsions in children with nephrotic syndrome

Rare (0.01% to 0.1%): Convulsions, partial and/or generalized in children and adults, ataxia, flaccid paresis

Very rare (less than 0.01%): Movement disorders (e.g., tremor, muscle twitching, myoclonus in the absence of convulsions, peripheral neuropathy[Ref]


Uncommon (0.1% to 1%): Rash

Rare (less than 0.1%): Stevens-Johnson syndrome, toxic epidermal necrolysis

Frequency not reported: Urticaria, angioneurotic edema, skin hypersensitivity (including rare reports of skin rash progressing to erythema multiforme)[Ref]


Common (1% to 10%): Nausea, vomiting, diarrhea, mouth ulceration[Ref]


Very rare (less than 0.01%): Interstitial pulmonary fibrosis, interstitial pneumonia[Ref]


Rare (less than 0.1%): Hepatotoxicity, jaundice[Ref]


Very rare (less than 0.01%): Sterile cystitis

Frequency not reported: Amenorrhea, azoospermia, infertility[Ref]


Common (1% to 10%): Acute secondary hematologic malignancies (especially leukemia and myelodysplastic syndrome), particularly after long term therapy[Ref]


Rare (less than 0.1%): Confusion, agitation, hallucinations[Ref]


Frequency not reported: Tremors, muscular twitching, myoclonia


Rare (less than 0.1%): Pyrexia


1. Rudd P, Fries JF, Epstein WV "Irreversible bone marrow failure with chlorambucil." J Rheumatol 2 (1975): 421-9

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

3. Williams SA, Makker SP, Grupe WE "Seizures: a significant side effect of chlorambucil therapy in children." J Pediatr 93 (1978): 516-8

4. Crestani B, Jaccard A, Israel-Biet D, Couderc LJ, Frija J, Clauvel JP "Chlorambucil-associated pneumonitis." Chest 105 (1994): 634-6

5. Giles FJ, Smith MP, Goldstone AH "Chlorambucil lung toxicity." Acta Haematol 83 (1990): 156-8

6. Patel SP, Nast CC, Adler SG "Chlorambucil-induced acute hepatic failure in a patient with membranous nephropathy." Am J Kidney Dis 36 (2000): 401-4

7. Palmer RG, Denman AM "Malignancies induced by chlorambucil." Cancer Treat Rev 11 (1984): 121-9

Further information

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

Some side effects may not be reported. You may report them to the FDA.