Leukeran (Chlorambucil) - Oral


Leukeran (chlorambucil) can cause severe decreases in blood counts, which can lead to infection and bleeding. It also has the possibility of causing cancer in humans. Leukeran also causes infertility. Tell your healthcare provider immediately if you develop unusual growths or lumps, swollen glands, and signs of infection (such as a sore throat that won't go away).

What Is Leukeran?

Leukeran (chlorambucil) is an oral medication in the class of antineoplastics, more specifically, an alkylating agent. It's used to treat certain types of cancers, including chronic lymphocytic leukemia (CLL), Hodgkin lymphoma, as well as some types of non-Hodgkin lymphomas.

Leukeran works by slowing down the growth of cancer cells. It is not a cure for these diseases, but it can help treat them and potentially reduce some symptoms.

Leukeran has the potential to cause other cancers, though how much Leukeran contributes to this risk is unknown. Still, you can talk to your healthcare provider about all potential safety considerations when starting treatment. 

Leukeran is available in tablet form to take by mouth.

Drug Facts

Generic Name: Chlorambucil

Brand Name(s): Leukeran

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antineoplastic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Chlorambucil

Dosage Form(s): Tablets

What Is Leukeran Used For?

Leukeran treats different types of leukemia and lymphoma, such as CLL, Hodgkin lymphoma, and some forms of non-Hodgkin lymphoma, such as giant follicular lymphoma.

When it is used for Hodgkin lymphoma, it is used in combination with chemotherapy medications.

How to Take Leukeran

Leukeran should be taken once a day. Drink plenty of fluids to help prevent side effects unless directed otherwise by your healthcare provider. It is best taken on an empty stomach, as having food in the stomach can decrease how much of the drug is absorbed.

In addition to taking Leukeran as prescribed, you'll need to undergo some important routine lab tests during treatment. These tests include a complete blood count (CBC) to closely monitor the white blood cells, red blood cells, and platelets and testing to evaluate liver function.


Keep your medication in its original container and store it in the refrigerator between 36 F and 46 F. Make sure the container is kept out of reach of children and pets.

Leukeran should only be handled by the person taking the medication. Wash your hands thoroughly after handling it.

Off-Label Uses 

Healthcare providers may prescribe chlorambucil for off-label uses, meaning for conditions not specifically indicated by the FDA.

There are a few off-label uses for which chlorambucil is a treatment option. These include:

  • Idiopathic membranous nephropathy, which affects the filtering units (glomeruli) inside the kidney
  • Necrobiotic xanthogranuloma, the abnormal development of lesions around the eyes due to the overgrowth of tissue
  • Waldenstrom’s macroglobulinemia, a type of lymphoma that causes large amounts of abnormal proteins to accumulate in the blood

How Long Does Leukeran Take to Work?

Leukeran is quickly absorbed once it enters the gastrointestinal tract. However, it may take a few weeks or months of therapy before any improvement is seen.

What Are the Side Effects of Leukeran?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects 

The common side effects associated with Leukeran include:

Severe Side Effects 

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Bone marrow suppression, which may cause symptoms of fatigue, pale skin, increased heart rate, dizziness, and shortness of breath
  • Seizures
  • Interstitial pneumonitis (inflammation of the lungs)
  • Skin hypersensitivity, including rare reports of Stevens-Johnson syndrome, which can cause flu-like symptoms and a painful, blistering rash

Long-Term Side Effects

Long-term side effects from Leukeran can occur.  These long-term effects can include the following:

Report Side Effects

Leukeran may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Leukeran Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For chronic lymphatic leukemia and other types of lymphoma:
      • Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.1 milligram (mg) per kilogram (kg) of body weight per day, taken as a single dose, for 3 to 6 weeks.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of Hodgkin's disease:
      • Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.2 milligram (mg) per kilogram (kg) of body weight per day, taken as a single dose, for 3 to 6 weeks.
      • Children—Use and dose must be determined by your doctor.


Certain factors may affect your dosage of this medication.

This is often due to significantly decreased blood cell counts. The size of the dose or how frequently the dose is taken may be modified based on blood tests.

Dose modifications may also need to be made if liver function is less than usual.

Missed Dose 

If you miss a dose, take it as soon as you remember. However, if it is closer to the next dose than the missed one, skip it and continue with your regular dosing schedule. Never double up on a missed dose.

Overdose: What Happens If I Take Too Much Leukeran?

Immediately notify your healthcare provider if you take too much Leukeran is taken. Too much of this medication can cause significant and possibly life-threatening effects.

Overdosing on Leukeran may result in the following:

  • Pancytopenia (low levels of all types of blood cells)
  • Agitation
  • Ataxia (loss of coordination)
  • Seizures

In the event of an overdose, you will likely be monitored by a healthcare provider and treated appropriately.

What Happens If I Overdose on Leukeran?

If you think you or someone else may have overdosed on Leukeran, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Leukeran, call 911 immediately.


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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests will be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

If you plan to have children, talk with your doctor before using this medicine. Some men and women using this medicine have become infertile (unable to have children).

Serious skin reactions can occur with this medicine. Stop using this medicine and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using this medicine.

While you are being treated with chlorambucil, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Chlorambucil may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Chlorambucil can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Check with your doctor right away if you have the following symptoms while taking this medicine: skin rash, fever, cough that won't go away, irregular monthly period, nausea or vomiting, seizures, unusual lumps, or yellow eyes or skin.

Make sure your doctor knows if you have had any other cancer treatments or radiation therapy within the past 4 weeks.

Cancer medicines can cause diarrhea, nausea, or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.

What Are Reasons I Shouldn’t Take Leukeran?

Do not take Leukeran while you are pregnant or breastfeeding.

It should also not be taken by anyone allergic to active or inactive ingredients.

What Other Medications Interact With Leukeran?

Before starting treatment, tell your healthcare provider about all your medications, including prescription and over-the-counter (OTC) drugs, vitamins, or herbal supplements.

Leukeran should be used cautiously in people on other medications known to cause low blood counts.

Also, avoid getting any live vaccines during your treatment. The antibody response of these vaccines may not work as well. Wait for a live vaccine at least three months after your last round of chemotherapy.

What Medications Are Similar?

Many other medications fall into the group of alkylating agents. These are used for various cancers, and not all for the exact types of cancers Leukeran is used for. These medications include:

  • Belrapzo, Bendeka, Treanda (bendamustine)
  • Carboplatin
  • Cisplatin
  • Cytoxan (cyclophosphamide)
  • Eloxatin (oxaliplatin)
  • Ifex (ifosfamide)

Frequently Asked Questions

  • What is Leukeran used for?

    Leukeran is used for certain types of lymphomas, such as Hodgkin’s lymphoma, as well as some types of non-Hodgkin lymphoma and a type of leukemia called CLL.

  • How does Leukeran work?

    Leukeran works by interfering with DNA or RNA inside the cancer cell. The damage that Leukeran causes prevents the cells from being able to divide normally.

  • What drugs should not be taken with Leukeran?

    Live vaccines should be avoided while taking Leukeran.

  • How do I stop taking Leukeran?

    Do not stop taking Leukeran unless instructed by your healthcare provider. Notify your healthcare team immediately if you are experiencing any significant side effects.

How Can I Stay Healthy While Taking Leukeran?

Starting cancer treatment can seem overwhelming. There is often a lot of information to digest. Remember that your cancer care team will answer your questions and help you better understand your medications during this time.

Live vaccines should not be received during your treatment course and for three months after. This is due to the risk of infection from viral shedding. Additionally, the medication can interfere with how well the vaccine works. Before starting treatment, work with your healthcare provider to ensure you are up-to-date on all necessary immunizations. Some vaccinations are recommended during cancer treatment, such as the flu shot.

While taking Leukeran, pay attention to how you are feeling. Don't hesitate to report any new or worsening side effects that arise from your therapy. It's also essential to keep all appointments recommended by your oncologist, especially for regular lab tests.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Leukeran label.

  2. Waldman M, Austin HA. Treatment of idiopathic membranous nephropathyJ Am Soc Nephrol. 2012;23(10):1617-1630. doi:10.1681/ASN.2012010058

  3. National Kidney Foundation. Membranous nephropathy.

  4. National Organization of Rare Disorders. Necrobiotic xanthogranuloma.

  5. Prescribers' Digital Reference. Chlorambucil - drug summary.

  6. PubChem. Chlorambucil.

  7. American Cancer Society. How does chemo work?

By Julie Scott, MSN, ANP-BC, AOCNP
Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community.