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Leukeran Warnings and Precautions
Before starting treatment with Leukeran, it is important to discuss your medical history with your healthcare provider. For example, people with a history of seizures, a head injury, or anemia may have an increased risk for serious problems with Leukeran. Safety precautions with this drug also include warnings of life-threatening skin reactions and problems associated with using it during pregnancy.
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You should talk with your healthcare provider prior to taking Leukeran® (chlorambucil) if you have:
- Liver disease, such as hepatitis, cirrhosis, or liver failure
- Kidney disease, such as kidney failure (renal failure)
- Received radiation treatment
- Received other chemotherapy treatment
- Low white blood cells
- Low platelets or anemia
- A history of seizures
- Ever had a head injury
- An infection or get infections easily
- Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of prior to taking this medication include the following:
- Leukeran can increase your risk for developing other cancers, including leukemia, in the future. People who take large doses or use the medication for extended periods of time likely have a higher risk. You and your healthcare provider should weigh the benefits of Leukeran treatment with the risk for future cancers.
- Leukeran can cause sterility (complete infertility) in both men and women. This side effect may be irreversible.
- There have been reports of serious skin rashes, including life-threatening rashes known as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), occurring in people taking this medicine. If you notice any skin rash while taking this medication, contact your healthcare provider right away.
- Like other chemotherapy medicines, Leukeran can cause life-threatening bone marrow suppression. As a result, your bone marrow may not produce necessary blood cells, which could cause the following problems:
- Anemia due to low red blood cells
- Increased susceptibility for infection due to low white blood cells (see Chemotherapy and Infections)
- Increased risk for bleeding due to low platelets (see Blood Clotting Problems and Chemotherapy).
Your healthcare provider will monitor your blood cell counts regularly during treatment, and may decrease your dosage if your blood cell counts drop too low.
- Some people who take this medicine may have an increased risk for seizures. This includes children and people receiving high intermittent doses. Your risk may be further increased if you have a history of seizures or a head injury.
- Leukeran may react with a few other medications (see Leukeran Drug Interactions).
- Leukeran is a pregnancy Category D medication, which means it may harm an unborn child if taken during pregnancy (see Leukeran and Pregnancy).
- It is unknown whether Leukeran passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Leukeran and Breastfeeding).
Written by/reviewed by: Susan Lakey, PharmD, MPH, BCPP
Last reviewed by: Kristi Monson, PharmD