Chlorambucil – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 49 min read
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Chlorambucil is an orally administered alkylating agent which is currently used in the therapy of chronic lymphocytic leukemia, Hodgkin and non-Hodgkin lymphomas, and rarely in severe autoimmune conditions including rheumatoid arthritis, uveitis, and nephrotic syndrome. Chlorambucil therapy has been associated with low rates of serum...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Chlorambucil is an orally administered alkylating agent which is currently used in the therapy of chronic lymphocytic leukemia, Hodgkin and non-Hodgkin lymphomas, and rarely in severe autoimmune conditions including rheumatoid arthritis, uveitis, and nephrotic syndrome. Chlorambucil therapy has been associated with low rates of serum enzyme elevations during therapy and with rare instances of an acute, clinically apparent injury. Chlorambucil is a monocarboxylic acid that...

Key Takeaways

  • This article explains Mechanism of Action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
  • This article explains Dosage in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

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See a doctor

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Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

Chlorambucil is an orally administered alkylating agent which is currently used in the therapy of chronic lymphocytic leukemia, Hodgkin and non-Hodgkin lymphomas, and rarely in severe autoimmune conditions including pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">arthritis: Rheumatoid arthritis is an autoimmune joint disease causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।" data-rx-term="rheumatoid arthritis" data-rx-definition="Rheumatoid arthritis is an autoimmune joint disease causing inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।">rheumatoid arthritis, uveitis, and nephrotic syndrome. Chlorambucil therapy has been associated with low rates of serum enzyme elevations during therapy and with rare instances of an acute, clinically apparent injury.

Chlorambucil is a monocarboxylic acid that is butanoic acid substituted at position 4 by a 4-[bis(2-chloroethyl)amino]phenyl group. A chemotherapy drug that can be used in combination with the antibody obinutuzumab for the treatment of chronic lymphocytic leukemia. It has a role as an alkylating agent, a carcinogenic agent, an antineoplastic agent, an immunosuppressive agent, and a drug allergen. It is a nitrogen mustard, an organochlorine compound, an aromatic amine, a tertiary amino compound, and a monocarboxylic acid.

Chlorambucil is an orally-active antineoplastic aromatic nitrogen mustard. Chlorambucil alkylates and cross-links DNA during all phases of the cell cycle, resulting in disruption of DNA function, cell cycle arrest, and apoptosis. (NCI04) A nitrogen mustard alkylating agent is used as antineoplastic agent for the treatment of various malignant and nonmalignant diseases. Although it is less toxic than most other nitrogen mustards, it has been listed as a known carcinogen in the Fourth Annual Report on Carcinogens (NTP 85-002, 1985). (Merck Index, 11th ed)

Mechanism of Action

Alkylating agents work by three different mechanisms: 1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA, 2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations.

or

As an alkylating agent, chlorambucil interferes with DNA replication and transcription of RNA and ultimately results in the disruption of nucleic acid function. In vitro studies have shown that the major metabolite of chlorambucil (phenylacetic acid mustard), which is also a bifunctional alkylating compound, has antineoplastic activity against some neoplastic human cell lines that are approximately equal to that of chlorambucil. Therefore, the major metabolite of chlorambucil may contribute to the in vivo antitumor activity of the drug. Chlorambucil also possesses some immunosuppressive activity, principally due to its suppression of lymphocytes. The drug is the slowest-acting and generally least toxic of the presently available nitrogen mustard derivatives.

Chlorambucil is an antineoplastic in the class of alkylating agents that is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands – directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result – disruption of DNA function and cell death.

Indications

  • For treatment of chronic lymphatic (lymphocytic) leukemia, childhood minimal-change nephrotic syndrome, and malignant lymphomas including lymphosarcoma, giant follicular lymphoma, Hodgkin’s disease, non-Hodgkin’s lymphomas, and Waldenström’s Macroglobulinemia.
  • Chlorambucil is approved for palliative treatment of Chronic lymphocytic leukemia, Hodgkin lymphoma, and Non-Hodgkin lymphoma (certain types).
  • Chlorambucil is indicated in the treatment of chronic lymphatic (lymphocytic) leukemia, malignant lymphomas including lymphosarcoma, giant follicular lymphoma, and Hodgkin’s disease. It is not curative in any of these disorders but may produce clinically useful palliation.
  • Chlorambucil is considered by many clinicians to be the drug of choice for the treatment of (Waldenstrom’s) macroglobulinemia.
  • Chlorambucil has also been used effectively with prednisone in the treatment of children with minimal-change nephrotic syndrome (lipoid nephrosis, idiopathic nephrotic syndrome of childhood) who have frequent relapses, require corticosteroid therapy to maintain remissions, or whose disease is resistant to steroid therapy. In most of these children, chlorambucil and prednisone therapy has induced long-term remissions and decreased the frequency of relapses. Although this type of nephrotic syndrome only occasionally occurs in adults, it is treated similarly.
  • Chronic Lymphocytic Leukemia (CLL)
  • Hodgkins Disease (HD)
  • Indolent Lymphoma
  • Lymphoma, Diffuse
  • MALT Lymphoma
  • Malignant Lymphomas
  • Mantle Cell Lymphoma (MCL)
  • Nephrotic syndrome with ulcer. সহজ বাংলা: শরীরের অস্বাভাবিক দাগ, ক্ষত বা ফোলা অংশ।" data-rx-term="lesion" data-rx-definition="A lesion is an abnormal area of tissue such as a spot, wound, patch, lump, or ulcer. সহজ বাংলা: শরীরের অস্বাভাবিক দাগ, ক্ষত বা ফোলা অংশ।">lesion of minimal change glomerulonephritis
  • Non-Hodgkin’s Lymphoma (NHL)
  • Waldenström’s Macroglobulinemia (WM)
  • Giant follicular lymphoma

Use in Cancer

CHLORAMBUCIL-PREDNISONE is used to treat:

This combination may also be used with other drugs or treatments or to treat other types of cancer.

Contraindications

  • are allergic to chlorambucil or any ingredients of this medication
  • have had a full course of radiation or chemotherapy within the previous 4 weeks
  • a bad infection
  • acute leukemia
  • decreased function of bone marrow
  • anemia
  • decreased blood platelets
  • low levels of white blood cells
  • low levels of a type of white blood cell called neutrophils
  • a decreased number of lymphocytes in the blood
  • a low seizure threshold
  • a type of infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the lung called interstitial pneumonitis
  • a condition where there is formation of fibrous tissue in the lung called pulmonary chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।" data-rx-term="fibrosis" data-rx-definition="Fibrosis means excess scar-like tissue formation after chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।">fibrosis
  • damage to the liver and infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation
  • liver problems
  • nephrotic syndrome, a type of kidney disorder
  • seizures
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • spread of malignant cancer to the bone marrow

Dosage

Strengths: 2 mg

Hodgkin’s Disease

NOTE: The literature and/or local protocol should be consulted for full details of the treatment schedules used.

For initiation of therapy or for short courses of treatment:

  • 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time
  • The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count.
  • Patients with Hodgkin’s disease usually require 0.2 mg/kg daily.
  • Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient).
  • Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses.

Chronic Lymphocytic Leukemia

For initiation of therapy or for short courses of treatment:

  • 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time
  • The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count.
  • Patients with Hodgkin’s disease usually require 0.2 mg/kg daily.
  • Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient).
  • Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses.

Lymphoma

NOTE: The literature and/or local protocol should be consulted for full details of the treatment schedules used.

For initiation of therapy or for short courses of treatment:

  • 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time
  • The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count.
  • Patients with Hodgkin’s disease usually require 0.2 mg/kg daily.
  • Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient).
  • Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses.

Usual Pediatric Dose

Non-Hodgkin’s Lymphoma

  • The manufacturer does not recommend the use of this drug in children; however, it has been used in children with Hodgkin’s disease and non-Hodgkin’s lymphoma. The dosage regimens are similar to those used in adults.

Hodgkin’s Disease

  • The manufacturer does not recommend the use of this drug in children; however, it has been used in children with Hodgkin’s disease and non-Hodgkin’s lymphoma. The dosage regimens are similar to those used in adults.

Side Effects

The Most Common

  • nausea
  • vomiting
  • sores in the mouth and throat
  • tiredness
  • missed menstrual periods (in girls and women)
  • skin rash
  • unusual bruising or bleeding
  • black, tarry stools
  • red urine
  • cough
  • sore throat
  • congestion
  • fever
  • difficulty breathing
  • seizures
  • yellowing of the skin or eyes
  • pain in the upper right part of the stomach
  • dark colored urine
  • frequent urination
  • unusual lumps or masses

More Common

  • allergic reaction (difficulty breathing, swelling in your face or throat, hives)
  • or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
  • a seizure
  • any unusual lump or mass,
  • severe diarrhea or vomiting,
  • a cough that is new or worsening,
  • signs of bone marrow suppression eg. dizziness, feeling tired or short of breath, pale lips or fingernail beds, fast heart rate,
  • signs of liver problems eg. low appetite,  pain in the upper right side of the stomach, dark urine, clay-colored stools, yellowing of the skin or eyes, or
  • signs of low blood cell count eg. high body temperature, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath.
  • nausea, vomiting, or diarrhea,
  • white patches or sores in or around your mouth,
  • bone marrow suppression,
  • low blood cell counts,
  • missed menstrual periods in women.

Rare

  • mouth ulcers
  • muscle twitching or jerking movements
  • muscle weakness or numbness
  • numbness or tingling in fingers and toes
  • persistent cough with shortness of breath
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of bladder inflammation (e.g., pain or burning with urination, frequent or urgent need to urinate)
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood,  bleeding gums, cuts that don’t stop bleeding)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • skin rash
  • symptoms of an infection such as fever, chills, or painful and difficult urination
  • tremors
  • blisters on skin
  • seizures
  • severe skin rash or skin blisters
  • symptoms of a serious allergic reaction such as hives; difficulty breathing; or swelling of the eyelids, throat, and mouth

Drug Interaction

Pregnancy and Lactation

FDA Pregnancy Category D

Pregnancy

There is a possibility of birth defects if either the man or woman is taking chlorambucil at the time of conception, or if it is taken during pregnancy. Infertility may occur with the use of chlorambucil. Use effective birth control while taking this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Lactation

This medication may pass into breast milk. Women taking this medication should not breastfeed. The safety and effectiveness of using this medication have not been established for children.

How should this medicine be used?

Chlorambucil comes as a tablet to take by mouth. It is usually taken once a day for 3 to 6 weeks, but sometimes may be taken intermittently, as a single dose once every 2 weeks, or as a single dose once a month. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have. Take chlorambucil at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take chlorambucil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may adjust your dose of chlorambucil depending on your response to treatment and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment. Do not stop taking chlorambucil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

What special precautions should I follow?

Before taking chlorambucil,

  • tell your doctor and pharmacist if you are allergic to chlorambucil, other alkylating agents such as bendamustine (Treanda), busulfan (Myleran, Busulfex), carmustine (BiCNU, Gliadel Wafer), cyclophosphamide (Cytoxan), ifosfamide (Ifex), lomustine (CeeNU), melphalan (Alkeran), procarbazine (Mutalane), or temozolomide (Temodar), any other medications, or any of the ingredients in chlorambucil. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
  • tell your doctor if you have taken chlorambucil before, but your cancer did not respond to the medication. Your doctor will probably tell you not to take chlorambucil.
  • tell your doctor if you have received radiation therapy or other chemotherapy within the last 4 weeks.
  • tell your doctor if you have ever had seizures or a head injury.
  • tell your doctor if you are breast-feeding.
  • do not have any vaccinations without talking to your doctor.

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician
Tests to discuss with doctor
  • Temperature chart and hydration assessment
  • CBC with platelet count if fever persists or dengue/other infection is possible
  • Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Chlorambucil – Uses, Dosage, Side Effects, Interaction

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Mechanism of Action Alkylating agents work by three different mechanisms: 1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA, 2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations. or As an alkylating agent, chlorambucil interferes with DNA replication and transcription of RNA and ultimately results in the disruption of nucleic acid function. In vitro studies have shown that the major metabolite of chlorambucil (phenylacetic acid mustard), which is also a bifunctional alkylating compound, has antineoplastic activity against some neoplastic human cell lines that are approximately equal to that of chlorambucil. Therefore, the major metabolite of chlorambucil may contribute to the in vivo antitumor activity of the drug. Chlorambucil also possesses some immunosuppressive activity, principally due to its suppression of lymphocytes. The drug is the slowest-acting and generally least toxic of the presently available nitrogen mustard derivatives. Chlorambucil is an antineoplastic in the class of alkylating agents that is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands - directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result - disruption of DNA function and cell death. Indications For treatment of chronic lymphatic (lymphocytic) leukemia, childhood minimal-change nephrotic syndrome, and malignant lymphomas including lymphosarcoma, giant follicular lymphoma, Hodgkin's disease, non-Hodgkin's lymphomas, and Waldenström’s Macroglobulinemia. Chlorambucil is approved for palliative treatment of Chronic lymphocytic leukemia, Hodgkin lymphoma, and Non-Hodgkin lymphoma (certain types). Chlorambucil is indicated in the treatment of chronic lymphatic (lymphocytic) leukemia, malignant lymphomas including lymphosarcoma, giant follicular lymphoma, and Hodgkin's disease. It is not curative in any of these disorders but may produce clinically useful palliation. Chlorambucil is considered by many clinicians to be the drug of choice for the treatment of (Waldenstrom's) macroglobulinemia. Chlorambucil has also been used effectively with prednisone in the treatment of children with minimal-change nephrotic syndrome (lipoid nephrosis, idiopathic nephrotic syndrome of childhood) who have frequent relapses, require corticosteroid therapy to maintain remissions, or whose disease is resistant to steroid therapy. In most of these children, chlorambucil and prednisone therapy has induced long-term remissions and decreased the frequency of relapses. Although this type of nephrotic syndrome only occasionally occurs in adults, it is treated similarly. Chronic Lymphocytic Leukemia (CLL) Hodgkins Disease (HD) Indolent Lymphoma Lymphoma, Diffuse MALT Lymphoma Malignant Lymphomas Mantle Cell Lymphoma (MCL) Nephrotic syndrome with lesion of minimal change glomerulonephritis Non-Hodgkin's Lymphoma (NHL) Waldenström's Macroglobulinemia (WM) Giant follicular lymphoma Use in Cancer CHLORAMBUCIL-PREDNISONE is used to treat: Chronic lymphocytic leukemia (CLL). This combination may also be used with other drugs or treatments or to treat other types of cancer. Contraindications are allergic to chlorambucil or any ingredients of this medication have had a full course of radiation or chemotherapy within the previous 4 weeks a bad infection acute leukemia decreased function of bone marrow anemia decreased blood platelets low levels of white blood cells low levels of a type of white blood cell called neutrophils a decreased number of lymphocytes in the blood a low seizure threshold a type of inflammation of the lung called interstitial pneumonitis a condition where there is formation of fibrous tissue in the lung called pulmonary fibrosis damage to the liver and inflammation liver problems nephrotic syndrome, a type of kidney disorder seizures pregnancy a patient who is producing milk and breastfeeding spread of malignant cancer to the bone marrow Dosage Strengths: 2 mg Hodgkin's Disease NOTE: The literature and/or local protocol should be consulted for full details of the treatment schedules used. For initiation of therapy or for short courses of treatment: 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count. Patients with Hodgkin's disease usually require 0.2 mg/kg daily. Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient). Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses. Chronic Lymphocytic Leukemia For initiation of therapy or for short courses of treatment: 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count. Patients with Hodgkin's disease usually require 0.2 mg/kg daily. Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient). Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses. Lymphoma NOTE: The literature and/or local protocol should be consulted for full details of the treatment schedules used. For initiation of therapy or for short courses of treatment: 0.1 to 0.2 mg/kg orally daily for 3 to 6 weeks as required; this usually amounts to 4 to 10 mg per day for the average patient; the entire daily dose may be given at one time The dosage should be adjusted according to the response of the patient and should be reduced as soon as there is an abrupt fall in the white blood cell count. Patients with Hodgkin's disease usually require 0.2 mg/kg daily. Patients with other lymphomas or chronic lymphocytic leukemia usually require 0.1 mg/kg daily. When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient). Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or once-monthly pulse doses have been reported. Intermittent schedules begin with an initial single dose of 0.4 mg/kg. Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity. It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily doses. Usual Pediatric Dose Non-Hodgkin's Lymphoma The manufacturer does not recommend the use of this drug in children; however, it has been used in children with Hodgkin's disease and non-Hodgkin's lymphoma. The dosage regimens are similar to those used in adults. Hodgkin's Disease The manufacturer does not recommend the use of this drug in children; however, it has been used in children with Hodgkin's disease and non-Hodgkin's lymphoma. The dosage regimens are similar to those used in adults. Side Effects The Most Common nausea vomiting sores in the mouth and throat tiredness missed menstrual periods (in girls and women) skin rash unusual bruising or bleeding black, tarry stools red urine cough sore throat congestion fever difficulty breathing seizures yellowing of the skin or eyes pain in the upper right part of the stomach dark colored urine frequent urination unusual lumps or masses More Common allergic reaction (difficulty breathing, swelling in your face or throat, hives) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). a seizure any unusual lump or mass, severe diarrhea or vomiting, a cough that is new or worsening, signs of bone marrow suppression eg. dizziness, feeling tired or short of breath, pale lips or fingernail beds, fast heart rate, signs of liver problems eg. low appetite,  pain in the upper right side of the stomach, dark urine, clay-colored stools, yellowing of the skin or eyes, or signs of low blood cell count eg. high body temperature, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath. nausea, vomiting, or diarrhea, white patches or sores in or around your mouth, bone marrow suppression, low blood cell counts, missed menstrual periods in women. Rare mouth ulcers muscle twitching or jerking movements muscle weakness or numbness numbness or tingling in fingers and toes persistent cough with shortness of breath signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath) signs of bladder inflammation (e.g., pain or burning with urination, frequent or urgent need to urinate) signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood,  bleeding gums, cuts that don't stop bleeding) signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools) skin rash symptoms of an infection such as fever, chills, or painful and difficult urination tremors blisters on skin seizures severe skin rash or skin blisters symptoms of a serious allergic reaction such as hives; difficulty breathing; or swelling of the eyelids, throat, and mouth Drug Interaction DRUG INTERACTION Abatacept The risk or severity of adverse effects can be increased when Chlorambucil is combined with Abatacept. Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Chlorambucil. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Chlorambucil. Acetazolamide The therapeutic efficacy of Acetazolamide can be decreased when used in combination with Chlorambucil. Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Chlorambucil. Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Chlorambucil. Adenovirus type 7 The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Chlorambucil. Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Chlorambucil. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Chlorambucil. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Chlorambucil. Allogeneic processed The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Chlorambucil. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Chlorambucil. Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Chlorambucil. Altretamine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Altretamine. Amifampridine The risk or severity of seizure can be increased when Chlorambucil is combined with Amifampridine. Amobarbital The therapeutic efficacy of Amobarbital can be decreased when used in combination with Chlorambucil. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Chlorambucil. Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Chlorambucil. Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Chlorambucil. Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Chlorambucil. Anifrolumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Anifrolumab. Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Chlorambucil. Anthrax immune globulin The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Chlorambucil. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Chlorambucil. Antilymphocyte The risk or severity of adverse effects can be increased when Chlorambucil is combined with Antilymphocyte immunoglobulin (horse). Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Chlorambucil. Antithrombin III human The risk or severity of bleeding can be increased when Antithrombin III human is combined with Chlorambucil. Antithymocyte The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Chlorambucil. Apixaban The risk or severity of bleeding can be increased when Apixaban is combined with Chlorambucil. Apremilast The risk or severity of adverse effects can be increased when Chlorambucil is combined with Apremilast. Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Chlorambucil. Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Chlorambucil. Arsenic trioxide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Arsenic trioxide. Articaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Articaine.  COVID-19 Vaccine The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Chlorambucil. Azacitidine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Azacitidine. Azathioprine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Azathioprine. Bacillus The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Chlorambucil. BCG-I live antigen The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Chlorambucil. calmette-guerin The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Chlorambucil. Baricitinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Chlorambucil. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Chlorambucil. Beclomethasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Beclomethasone dipropionate. Belatacept The risk or severity of adverse effects can be increased when Chlorambucil is combined with Belatacept. Belimumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Belimumab. Belinostat The risk or severity of adverse effects can be increased when Chlorambucil is combined with Belinostat. Belumosudil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Belumosudil. Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Chlorambucil. Bendamustine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Bendamustine. Bendroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Chlorambucil. Benzocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Chlorambucil. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Benzyl alcohol. Betamethasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Betamethasone. Betrixaban The risk or severity of bleeding can be increased when Betrixaban is combined with Chlorambucil. Bexarotene The risk or severity of adverse effects can be increased when Chlorambucil is combined with Bexarotene. Bimekizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Bimekizumab. Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Chlorambucil. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Chlorambucil. Blinatumomab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Blinatumomab. Bordetella The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Chlorambucil. Bortezomib The risk or severity of adverse effects can be increased when Bortezomib is combined with Chlorambucil. Bosutinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Bosutinib. Brentuximab vedotin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Brentuximab vedotin. Brexanolone The therapeutic efficacy of Brexanolone can be decreased when used in combination with Chlorambucil. Brivaracetam The therapeutic efficacy of Brivaracetam can be decreased when used in combination with Chlorambucil. Brodalumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Brodalumab. Budesonide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Budesonide. Bupivacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Bupivacaine. Bupropion The risk or severity of seizure can be increased when Bupropion is combined with Chlorambucil. Busulfan The risk or severity of adverse effects can be increased when Chlorambucil is combined with Busulfan. Butacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Butacaine. Butalbital The therapeutic efficacy of Butalbital can be decreased when used in combination with Chlorambucil. Butamben The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Butamben. Cabazitaxel The risk or severity of adverse effects can be increased when Chlorambucil is combined with Cabazitaxel. Canakinumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Canakinumab. Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Chlorambucil. Cannabidiol The therapeutic efficacy of Cannabidiol can be decreased when used in combination with Chlorambucil. Capecitabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Capecitabine. Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Chlorambucil. Capsaicin The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Capsaicin. Carbamazepine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Carbamazepine. Carboplatin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Carboplatin. Carfilzomib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Carfilzomib. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Chlorambucil. Cenobamate The therapeutic efficacy of Cenobamate can be decreased when used in combination with Chlorambucil. Certolizumab pegol The risk or severity of adverse effects can be increased when Chlorambucil is combined with Certolizumab pegol. Chloramphenicol The risk or severity of adverse effects can be increased when Chlorambucil is combined with Chloramphenicol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Chloroprocaine. Chlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Chlorambucil. Ciclesonide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ciclesonide. Cilostazol The risk or severity of bleeding can be increased when Cilostazol is combined with Chlorambucil. Cinchocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Cinchocaine. Cisplatin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Cisplatin. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Chlorambucil. Clobazam The therapeutic efficacy of Clobazam can be decreased when used in combination with Chlorambucil. Clobetasol propionate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Clobetasol propionate. Clofarabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Clofarabine. Clonazepam The therapeutic efficacy of Clonazepam can be decreased when used in combination with Chlorambucil. Clozapine The risk or severity of neutropenia can be increased when Chlorambucil is combined with Clozapine. Cocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Cocaine. Corticotropin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Corticotropin. Cortisone acetate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Cortisone acetate. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Chlorambucil. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Chlorambucil. Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Chlorambucil. Cyclophosphamide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Cyclophosphamide. Cyclosporine Chlorambucil may increase the immunosuppressive activities of Cyclosporine. Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Chlorambucil. Cytarabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Cytarabine. Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Chlorambucil. Dabigatran etexilate The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Chlorambucil. Dacarbazine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dacarbazine. Dactinomycin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dactinomycin. Dalfampridine The risk or severity of seizure can be increased when Chlorambucil is combined with Dalfampridine. Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Chlorambucil. Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Chlorambucil. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Chlorambucil. Dasatinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dasatinib. Daunorubicin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Daunorubicin. Decitabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Decitabine. Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Chlorambucil. Deflazacort The risk or severity of adverse effects can be increased when Chlorambucil is combined with Deflazacort. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Chlorambucil. Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Chlorambucil. Desoximetasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Desoximetasone. Deucravacitinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Deucravacitinib. Dexamethasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dexamethasone. Dexrazoxane The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dexrazoxane. Dextran The risk or severity of bleeding can be increased when Dextran is combined with Chlorambucil. Diazepam The therapeutic efficacy of Diazepam can be decreased when used in combination with Chlorambucil. Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Chlorambucil. Difluocortolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Difluocortolone. Dimethyl fumarate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dimethyl fumarate. Dinutuximab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dinutuximab. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Diphenhydramine. Dipyridamole The risk or severity of bleeding can be increased when Dipyridamole is combined with Chlorambucil. Diroximel fumarate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Diroximel fumarate. Docetaxel The risk or severity of adverse effects can be increased when Chlorambucil is combined with Docetaxel. Doxorubicin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Doxorubicin. Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Chlorambucil. Dyclonine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Dyclonine. Ebola Zaire vaccine The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Chlorambucil. Eculizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Eculizumab. Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Chlorambucil. Edoxaban The risk or severity of bleeding can be increased when Edoxaban is combined with Chlorambucil. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Chlorambucil. Emapalumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Emapalumab. Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Chlorambucil. Epirubicin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Epirubicin. Epoprostenol The risk or severity of bleeding can be increased when Epoprostenol is combined with Chlorambucil. Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Chlorambucil. Eribulin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Eribulin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Chlorambucil. Eslicarbazepine The therapeutic efficacy of Eslicarbazepine can be decreased when used in combination with Chlorambucil. Eslicarbazepine acetate The therapeutic efficacy of Eslicarbazepine acetate can be decreased when used in combination with Chlorambucil. Estazolam The therapeutic efficacy of Estazolam can be decreased when used in combination with Chlorambucil. Estramustine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Estramustine. Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Chlorambucil. Ethosuximide The therapeutic efficacy of Ethosuximide can be decreased when used in combination with Chlorambucil. Ethotoin The therapeutic efficacy of Ethotoin can be decreased when used in combination with Chlorambucil. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Etidocaine. Etoposide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Etoposide. Everolimus The risk or severity of adverse effects can be increased when Chlorambucil is combined with Everolimus. Ezogabine The therapeutic efficacy of Ezogabine can be decreased when used in combination with Chlorambucil. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Chlorambucil. Felbamate The therapeutic efficacy of Felbamate can be decreased when used in combination with Chlorambucil. Fenfluramine The therapeutic efficacy of Fenfluramine can be decreased when used in combination with Chlorambucil. Filgotinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Filgotinib. Fingolimod Chlorambucil may increase the immunosuppressive activities of Fingolimod. Floxuridine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Floxuridine. Flucytosine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Flucytosine. Fludarabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fludarabine. Fludrocortisone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fludrocortisone. Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Chlorambucil. Flunarizine The therapeutic efficacy of Flunarizine can be decreased when used in combination with Chlorambucil. Flunisolide The risk or severity of adverse effects can be increased when Flunisolide is combined with Chlorambucil. Fluocinolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluocinolone acetonide. Fluocinonide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluocinonide. Fluocortolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluocortolone. Fluorometholone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluorometholone. Fluorouracil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluorouracil. Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Chlorambucil. Fluprednisolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluprednisolone. Fluticasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluticasone. Fluticasone furoate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluticasone furoate. Fluticasone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Fluticasone propionate. Fondaparinux The risk or severity of bleeding can be increased when Fondaparinux is combined with Chlorambucil. Fosphenytoin The therapeutic efficacy of Fosphenytoin can be decreased when used in combination with Chlorambucil. Gabapentin The therapeutic efficacy of Gabapentin can be decreased when used in combination with Chlorambucil. Gallium nitrate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Gallium nitrate. Gemcitabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Gemcitabine. Gemtuzumab ozogamicin The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Chlorambucil. Glatiramer The risk or severity of adverse effects can be increased when Chlorambucil is combined with Glatiramer. Golimumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Golimumab. Lacosamide The therapeutic efficacy of Lacosamide can be decreased when used in combination with Chlorambucil. Lamotrigine The therapeutic efficacy of Lamotrigine can be decreased when used in combination with Chlorambucil. Leflunomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Leflunomide. Lenalidomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Lenalidomide. Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Chlorambucil. Levetiracetam The therapeutic efficacy of Levetiracetam can be decreased when used in combination with Chlorambucil. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Levobupivacaine. Lidocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Lidocaine. Linezolid The risk or severity of adverse effects can be increased when Chlorambucil is combined with Linezolid. Lipegfilgrastim Chlorambucil may increase the myelosuppressive activities of Lipegfilgrastim. Lomustine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Lomustine. Lopinavir The serum concentration of Chlorambucil can be increased when it is combined with Lopinavir. Lorazepam The therapeutic efficacy of Lorazepam can be decreased when used in combination with Chlorambucil. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Chlorambucil. Magnesium sulfate The therapeutic efficacy of Magnesium sulfate can be decreased when used in combination with Chlorambucil. Measles virus vaccine The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Chlorambucil. Mechlorethamine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mechlorethamine. Meloxicam The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Meloxicam. Melphalan The risk or severity of adverse effects can be increased when Chlorambucil is combined with Melphalan. Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Chlorambucil. Mephenytoin The therapeutic efficacy of Mephenytoin can be decreased when used in combination with Chlorambucil. Mepivacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mepolizumab. Meprednisone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Meprednisone. Mercaptopurine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mercaptopurine. Metamizole The risk or severity of myelosuppression can be increased when Metamizole is combined with Chlorambucil. Methimazole The risk or severity of adverse effects can be increased when Chlorambucil is combined with Methimazole. Methohexital The therapeutic efficacy of Methohexital can be decreased when used in combination with Chlorambucil. Methotrexate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Methotrexate. Methoxy polyethylene The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Chlorambucil. Methsuximide The therapeutic efficacy of Methsuximide can be decreased when used in combination with Chlorambucil. Methylphenobarbital The therapeutic efficacy of Methylphenobarbital can be decreased when used in combination with Chlorambucil. Methylprednisolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Methylprednisolone. Mitomycin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mitomycin. Mitoxantrone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mitoxantrone.  COVID-19 Vaccine The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Chlorambucil. Modified vaccinia The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Chlorambucil. Mometasone furoate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mometasone furoate. Monomethyl fumarate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Monomethyl fumarate. Mosunetuzumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mosunetuzumab. Mumps virus The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Chlorambucil. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Chlorambucil. Mycophenolate mofetil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mycophenolate mofetil. Mycophenolic acid The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mycophenolic acid. Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Chlorambucil. Natalizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Natalizumab. Nelarabine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Nelarabine. Nilotinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Nilotinib. Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Chlorambucil. Nitrazepam The therapeutic efficacy of Nitrazepam can be decreased when used in combination with Chlorambucil. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Chlorambucil. Obinutuzumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Obinutuzumab. Ocrelizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ocrelizumab. Ofatumumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ofatumumab. Olaparib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Olaparib. Oxaliplatin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Oxaliplatin. Oxcarbazepine The therapeutic efficacy of Oxcarbazepine can be decreased when used in combination with Chlorambucil. Oxetacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Oxybuprocaine. Ozanimod The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ozanimod. Paclitaxel The risk or severity of adverse effects can be increased when Chlorambucil is combined with Paclitaxel. Palbociclib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Palbociclib. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Chlorambucil. Panobinostat The risk or severity of adverse effects can be increased when Chlorambucil is combined with Panobinostat. Paraldehyde The therapeutic efficacy of Paraldehyde can be decreased when used in combination with Chlorambucil. Paramethadione The therapeutic efficacy of Paramethadione can be decreased when used in combination with Chlorambucil. Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Chlorambucil. Pazopanib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pazopanib. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Chlorambucil. Pegcetacoplan The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Chlorambucil. Peginterferon The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Chlorambucil. Peginterferon The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Chlorambucil. Peginterferon The risk or severity of adverse effects can be increased when Chlorambucil is combined with Peginterferon beta-1a. Pemetrexed The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pemetrexed. Penicillamine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Penicillamine. Pentobarbital The therapeutic efficacy of Pentobarbital can be decreased when used in combination with Chlorambucil. Pentosan polysulfate The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Chlorambucil. Pentostatin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pentostatin. Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Chlorambucil. Perampanel The therapeutic efficacy of Perampanel can be decreased when used in combination with Chlorambucil. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Chlorambucil. Phenacemide The therapeutic efficacy of Phenacemide can be decreased when used in combination with Chlorambucil. Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Chlorambucil. Phenobarbital The therapeutic efficacy of Phenobarbital can be decreased when used in combination with Chlorambucil. Phenol The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Phenol. Phenprocoumon The risk or severity of bleeding can be increased when Phenprocoumon is combined with Chlorambucil. Phensuximide The therapeutic efficacy of Phensuximide can be decreased when used in combination with Chlorambucil. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Chlorambucil. Phenylbutazone The risk or severity of adverse effects can be increased when Phenylbutazone is combined with Chlorambucil. Phenytoin The therapeutic efficacy of Phenytoin can be decreased when used in combination with Chlorambucil. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Chlorambucil. Pirfenidone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pirfenidone. Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Chlorambucil. Pomalidomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pomalidomide. Ponatinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ponatinib. Ponesimod The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ponesimod. Pralatrexate The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pralatrexate. Pramocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Pramocaine. Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Chlorambucil. Prednisolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Prednisolone. Prednisone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Prednisone. Pregabalin The therapeutic efficacy of Pregabalin can be decreased when used in combination with Chlorambucil. Prilocaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Prilocaine. Primidone The therapeutic efficacy of Primidone can be decreased when used in combination with Chlorambucil. Procaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Procarbazine. Proparacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Proparacaine. Propoxycaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Propoxycaine. Propylthiouracil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Propylthiouracil. Protein C The risk or severity of bleeding can be increased when Protein C is combined with Chlorambucil. Protein S human The risk or severity of bleeding can be increased when Protein S human is combined with Chlorambucil. Rabies immune The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Chlorambucil.  inactivated antigen The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Chlorambucil.  antigen, B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Chlorambucil. Raltitrexed The risk or severity of adverse effects can be increased when Chlorambucil is combined with Raltitrexed. Ravulizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ravulizumab. Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Chlorambucil. Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Chlorambucil. Rilonacept The risk or severity of adverse effects can be increased when Chlorambucil is combined with Rilonacept. Riluzole The therapeutic efficacy of Riluzole can be decreased when used in combination with Chlorambucil. Risankizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Risankizumab. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Chlorambucil. Rivaroxaban The risk or severity of bleeding can be increased when Rivaroxaban is combined with Chlorambucil. Roflumilast Roflumilast may increase the immunosuppressive activities of Chlorambucil. Ropeginterferon The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ropeginterferon alfa-2b. Ropivacaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Ropivacaine. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Chlorambucil. Rubella virus vaccine The risk or severity of infection can be increased when Rubella virus vaccine is combined with Chlorambucil. Rufinamide The therapeutic efficacy of Rufinamide can be decreased when used in combination with Chlorambucil. Ruxolitinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ruxolitinib. Sarilumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Sarilumab. Satralizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Satralizumab. Secobarbital The therapeutic efficacy of Secobarbital can be decreased when used in combination with Chlorambucil. Secukinumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Secukinumab. Siltuximab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Siltuximab. Siponimod The risk or severity of adverse effects can be increased when Chlorambucil is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Chlorambucil. Sirolimus The risk or severity of adverse effects can be increased when Chlorambucil is combined with Sirolimus. Smallpox The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Chlorambucil. Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Chlorambucil. Sorafenib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Sorafenib. Spesolimab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Spesolimab. Stiripentol The therapeutic efficacy of Stiripentol can be decreased when used in combination with Chlorambucil. Streptokinase The risk or severity of bleeding can be increased when Streptokinase is combined with Chlorambucil. Streptozocin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Streptozocin. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Chlorambucil. Sulfasalazine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Sulfasalazine. Sulfinpyrazone The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Chlorambucil. Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Chlorambucil. Sulthiame The therapeutic efficacy of Sulthiame can be decreased when used in combination with Chlorambucil. Sunitinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Sunitinib. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Chlorambucil. Tedizolid phosphate The risk or severity of myelosuppression can be increased when Chlorambucil is combined with Tedizolid phosphate. Temozolomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Temozolomide. Temsirolimus The risk or severity of adverse effects can be increased when Chlorambucil is combined with Temsirolimus. Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Chlorambucil. Teniposide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Teniposide. Teprotumumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Teprotumumab. Teriflunomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Teriflunomide. Tetracaine The risk or severity of methemoglobinemia can be increased when Chlorambucil is combined with Tetracaine. Thalidomide The risk or severity of adverse effects can be increased when Chlorambucil is combined with Thalidomide. Thiamylal The therapeutic efficacy of Thiamylal can be decreased when used in combination with Chlorambucil. Thiopental The therapeutic efficacy of Thiopental can be decreased when used in combination with Chlorambucil. Thiotepa The risk or severity of adverse effects can be increased when Chlorambucil is combined with Thiotepa. Tiagabine The therapeutic efficacy of Tiagabine can be decreased when used in combination with Chlorambucil. Ticagrelor The risk or severity of bleeding can be increased when Ticagrelor is combined with Chlorambucil. Tick-borne encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Chlorambucil. Ticlopidine The risk or severity of bleeding can be increased when Ticlopidine is combined with Chlorambucil. Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Chlorambucil. Tioguanine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Tioguanine. Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Chlorambucil. Tixocortol The risk or severity of adverse effects can be increased when Chlorambucil is combined with Tixocortol. Tizanidine The therapeutic efficacy of Tizanidine can be decreased when used in combination with Chlorambucil. Tocilizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Tocilizumab. Tofacitinib Chlorambucil may increase the immunosuppressive activities of Tofacitinib. Topiramate The therapeutic efficacy of Topiramate can be decreased when used in combination with Chlorambucil. Topotecan The risk or severity of adverse effects can be increased when Chlorambucil is combined with Topotecan. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Chlorambucil. Trabectedin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Trabectedin. Trastuzumab Trastuzumab may increase the neutropenic activities of Chlorambucil. Trastuzumab emtansine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Trastuzumab emtansine. Tretinoin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Tretinoin. Triamcinolone The risk or severity of adverse effects can be increased when Chlorambucil is combined with Triamcinolone. Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Chlorambucil. Trifluridine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Trifluridine. Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Chlorambucil. Trilostane The risk or severity of adverse effects can be increased when Chlorambucil is combined with Trilostane. Trimethadione The therapeutic efficacy of Trimethadione can be decreased when used in combination with Chlorambucil. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Chlorambucil. Typhoid Vaccine Live The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Chlorambucil. Typhoid Vi The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Chlorambucil. Upadacitinib The risk or severity of adverse effects can be increased when Chlorambucil is combined with Upadacitinib. Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Chlorambucil. Valproic acid The therapeutic efficacy of Valproic acid can be decreased when used in combination with Chlorambucil. Varicella zoster vaccine The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Chlorambucil. Varicella zoster The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Chlorambucil. Vedolizumab The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vedolizumab. Vibrio cholerae The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Chlorambucil. Vigabatrin The therapeutic efficacy of Vigabatrin can be decreased when used in combination with Chlorambucil. Vilanterol The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vilanterol. Vinblastine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vinblastine. Vincristine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vincristine. Vindesine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vindesine. Vinorelbine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vinorelbine. Voclosporin The risk or severity of adverse effects can be increased when Chlorambucil is combined with Voclosporin. Vorapaxar The risk or severity of bleeding can be increased when Vorapaxar is combined with Chlorambucil. Vorinostat The risk or severity of adverse effects can be increased when Chlorambucil is combined with Vorinostat. Warfarin The risk or severity of bleeding can be increased when Warfarin is combined with Chlorambucil. Ximelagatran The risk or severity of bleeding can be increased when Ximelagatran is combined with Chlorambucil. Yellow fever The risk or severity of infection can be increased when Yellow fever vaccine is combined with Chlorambucil. Zaleplon The therapeutic efficacy of Zaleplon can be decreased when used in combination with Chlorambucil. Zidovudine The risk or severity of adverse effects can be increased when Chlorambucil is combined with Zidovudine. Zonisamide The therapeutic efficacy of Zonisamide can be decreased when used in combination with Chlorambucil. Pregnancy and Lactation FDA Pregnancy Category D Pregnancy There is a possibility of birth defects if either the man or woman is taking chlorambucil at the time of conception, or if it is taken during pregnancy. Infertility may occur with the use of chlorambucil. Use effective birth control while taking this medication. If you become pregnant while taking this medication, contact your doctor immediately. Lactation This medication may pass into breast milk. Women taking this medication should not breastfeed. The safety and effectiveness of using this medication have not been established for children. How should this medicine be used?

Chlorambucil comes as a tablet to take by mouth. It is usually taken once a day for 3 to 6 weeks, but sometimes may be taken intermittently, as a single dose once every 2 weeks, or as a single dose once a month. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have. Take chlorambucil at around the same time every day. Follow…

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