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In these cases chlorambucil may be given in the customary dosage. It is presently felt that short courses of treatment are safer than continuous maintenance therapy, although both methods have been effective. It must be recognized that continuous therapy may give the appearance of "maintenance" in patients who are actually in remission and have no immediate need for further drug. If maintenance dosage is used, it should not exceed 0.1 mg/kg daily and may well be as low as 0.03 mg/kg daily. A typical maintenance dose is 2 mg to 4 mg daily, or less, depending on the status of the blood counts.
Drug Class And MechanismSubsequently, the neutrophil count usually rapidly returns to normal. Doses of Leukeran should not be missed. If a dose is missed, however, take it as soon as remembered. If you experience any of these side effects, continue using the product but inform your doctor immediately. Other side effects may also occur when you take Leukeran. Tremors, muscular twitching, myoclonia, confusion, agitation, ataxia, flaccid paresis, and hallucinations have been reported as rare adverse experiences to chlorambucil which resolve upon discontinuation of drug. Allergic reactions such as urticaria and angioneurotic edema have been reported following initial or subsequent dosing. Leukeran Intake GuidelinesSymptoms of overdose of Leukeran include the following: Agitation , Convulsions , Unsteadiness while walking . If you experience any of these symptoms, you may be experiencing overdose. Seek immediate medical attention or call poison control. Nausea, vomiting, or changes in menstrual period are common side effects. Taking the medication on an empty stomach with a full glass of water may help relieve vomiting. Changes in dieting such as eating several small meals or limited activity may help lessen some of these effects. In some cases, drug therapy may be necessary to prevent or relieve nausea and vomiting. Contact your doctor without delay if you experience any of the following symptoms: fever, , chills, , painful or difficult urination, , easy bruising or bleeding, , tarry stools, , blood in urine or stools,, small red spots on the skin, , joint pain, , swollen feet or lower legs, , sores in mouth or on lips, , yellow eyes or skin, , cough, , lower back or side pain, , stomach pain,, trouble walking,, muscle twitching, , agitation, , confusion, , hallucinations,, weakness,, paralysis. PrecautionsAlthough bone marrow suppression frequently occurs, it is usually reversible if the chlorambucil is withdrawn early enough. As much as 50 mg/kg has been given orally to rats as a single dose, with recovery. It is not known whether this drug is excreted in human milk. Neurological toxicity ranging from agitated behavior and ataxia to multiple grand mal seizures has also occurred. The most common side effect is bone marrow suppression, anemia, leukopenia, neutropenia, thrombocytopenia, or pancytopenia. As there is no known antidote, the blood picture should be closely monitored and general supportive measures should be instituted, together with appropriate blood transfusions, if necessary. Leukeran Adverse ReactionsReversible pancytopenia was the main finding of inadvertent overdoses of chlorambucil. Chlorambucil is not dialyzable. In rats, a single intraperitoneal dose of 12.5 mg/kg of chlorambucil produces typical nitrogen-mustard effects; these include atrophy of the intestinal mucous membrane and lymphoid tissues, severe lymphopenia becoming maximal in 4 days, anemia, and thrombocytopenia. Oral LD 50 single doses in mice are 123 mg/kg. After this dose, the animals begin to recover within 3 days and appear normal in about a week, although the bone marrow may not become completely normal for about 3 weeks. |
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