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Chlorambucil Side Effects

For the Consumer

Applies to chlorambucil: oral tablet

Along with its needed effects, chlorambucil may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking chlorambucil:

More Common

  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chest pain
  • cough or hoarseness, accompanied by fever or chills
  • fever or chills
  • lower back or side pain, accompanied by fever or chills
  • painful or difficult urination, accompanied by fever or chills
  • pinpoint red spots on the skin
  • shortness of breath
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less Common

  • Itching
  • joint pain
  • large, swollen hives
  • skin rash
  • swelling of the feet or lower legs

Rare

  • Blistering, peeling, or loosening of the skin
  • diarrhea
  • muscle pain
  • muscle twitching
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • seizures
  • shakiness and unsteady walk
  • shakiness in the legs, arms, hands, or feet
  • sore throat
  • sudden jerky movements of the body
  • unsteadiness, trembling, or other problems with muscle control or coordination

Incidence Not Known

  • Abdominal or stomach pain or tenderness
  • bone pain
  • clay colored stools
  • dark urine
  • decreased appetite
  • difficult breathing
  • headache
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • trouble getting pregnant
  • troubled or quick, shallow breathing
  • yellow eyes or skin

Some side effects of chlorambucil may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less Common

Rare

  • Anxiety
  • confusion
  • dry mouth
  • hyperventilation
  • irregular heartbeats
  • irritability
  • no muscle tone or movement
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • trouble sleeping

Incidence Not Known

For Healthcare Professionals

Applies to chlorambucil: compounding powder, oral tablet

Hematologic

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]

Dermatologic

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]

Gastrointestinal

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

Respiratory

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

Hepatic

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

Genitourinary

Very rare (less than 0.01%): Sterile cystitis

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

Oncologic

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

Psychiatric

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

Musculoskeletal

Frequency not reported: Tremors, muscular twitching, myoclonia

Other

Rare (less than 0.1%): Pyrexia

References

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

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

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.

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