INTRODUCTION
CLOKERAN 5MG TABLET contains Chlorambucil which belongs to a group of medicines called Antineoplastics. It is used to treat Hodgkin's disease and Non-Hodgkin’s Lymphoma (cancer of the lymphatic system), Chronic lymphocytic leukaemia (a type of white blood cell cancer where the bone marrow produces a large number of abnormal white cells).
CLOKERAN 5MG TABLET is also used to treat Waldenstrom's macroglobulinaemia (a rare lymphoma associated with an abnormal increase of B-cells, a type of white blood cell, resulting in the release of an abnormal protein into the blood).
CLOKERAN 5MG TABLET should be used with caution in patients with liver, kidney disease and fits. CLOKERAN 5MG TABLET is not recommended for use in pregnant and breastfeeding women. Consult your doctor before taking it.
CLOKERAN 5MG TABLET should be used with caution in children and in elderly patients. Consult your doctor before taking it. The most common side effects of taking CLOKERAN 5MG TABLET are nausea, vomiting, diarrhea, mouth ulcers (sores), fits in children with a kidney problem known as nephrotic syndrome. Contact your doctor if any of the symptoms worsen.
USES OF CLOKERAN 5MG TABLET
Treats:
- Hodgkin's disease and Non-Hodgkin’s Lymphoma
- Chronic lymphocytic leukemia
- Waldenstrom's macroglobulinaemia
HOW CLOKERAN 5MG TABLET WORKS
CLOKERAN 5MG TABLET belongs to a group of medicines called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.
DIRECTIONS FOR USE
Take CLOKERAN 5MG TABLET as advised by your physician. Swallow CLOKERAN 5MG TABLET with a glass of water and do not chew or crush the medicine. CLOKERAN 5MG TABLET should be taken daily on an empty stomach (at least one hour before meals or three hours after meals). Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF CLOKERAN 5MG TABLET
COMMON
- nausea, vomiting, diarrhea, mouth ulcers (sores)
- secondary blood cancers (acute secondary hematologic malignancies)
- fits (convulsions) in children with a kidney problem known as nephrotic syndrome
UNCOMMON
- rash
RARE
- allergy symptoms such as skin lumps, hives (urticaria) or swelling of the tissues (oedema)
- fever
- fit or convulsion
- liver damage/injury (hepatotoxicity), yellowing of the whites of the eyes or skin (jaundice)
Stop taking CLOKERAN 5MG TABLET and consult with your doctor immediately if you experience any of the following symptoms:
- signs of fever or infection (sore throat, sore mouth or urinary problems)
- any unexpected bruising or bleeding due to a decrease in a certain types of blood cells
- suddenly feel unwell (even with a normal temperature)
- feeling extremely tired
- numbness or weakness of your muscles
- skin rash has been progressing to serious conditions called Stevens-Johnson syndrome and toxic epidermal necrolysis causing skin rashes, skin peeling, blisters on the skin, sore mouth or eyes and fever
HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Take this medicine with or just after a meal or a snack. Stick to simple meals. Avoid eating oily rich or spicy food. Contact your doctor if your nausea and vomiting did not improve.
Skin rash:
Avoid hot baths because hot water can irritate your skin further. Do not scratch the affected area. Use sunscreen and wear protective clothing while going outside. Use unscented moisturizers to soothe and hydrate the affected area. Contact your doctor if your rashes worsen.
Diarrhoea:
Drink lots of fluids, such as water or fruit juices to keep yourself hydrated. Do not take any medicine on your own for treating diarrhoea. Contact your doctor if your diarrhoea did not improve.
WARNING & PRECAUTIONS
PREGNANCY
CLOKERAN 5MG TABLET is not recommended for use in pregnant women or are planning for pregnancy because it may cause permanent damage to a foetus. Contact your doctor before taking this medicine.
Women of childbearing potential should be advised to use a reliable form of contraception to avoid becoming pregnant if either you or your partner is taking CLOKERAN 5MG TABLET.
BREASTFEEDING
CLOKERAN 5MG TABLET is not recommended for use in breastfeeding women as it may pass through the breast milk. Consult your doctor before taking it.
DRIVING AND USING MACHINES
There is no information on the effects of CLOKERAN 5MG TABLET on the ability to drive and use machines is available.
KIDNEY
CLOKERAN 5MG TABLET should be used with caution in patients with kidney disease (nephrotic syndrome). Consult your doctor before taking it.
LIVER
CLOKERAN 5MG TABLET should be used with caution in patients with liver disease. Consult your doctor before taking it.
ALLERGY
Do not take CLOKERAN 5MG TABLET if you are allergic to Chlorambucil or any other ingredients of this medicine.
OTHERS
Before taking CLOKERAN 5MG TABLET, inform your doctor if you:
- have been recently vaccinated or planning to be vaccinated with a live vaccine
- are scheduled for bone marrow transplantation
- have had radiotherapy or chemotherapy, now or recently
- ever had a fit or head trauma
- have an intolerance to lactose or other sugars
Use in Paediatrics:
CLOKERAN 5MG TABLET should be used with caution in children. Consult your doctor before taking it.
Use in Geriatrics:
CLOKERAN 5MG TABLET should be used with caution in elderly patients and may require dose adjustment. Consult your doctor before taking it.
INTERACTIONS
A. Drug-Drug Interactions:
Before taking CLOKERAN 5MG TABLET, inform your doctor, if you are taking any of the following medicine:
- live vaccines Ex. oral polio vaccine, measles, mumps, rubella) (used to prevent infections)
- a medicine used to treat fever, pain and inflammation in the body (Ex. phenylbutazone)
- medicines used for cancer that affect blood, bone marrow and lymph nodes (Ex. fludarabine, pentostatin, cladribine)
Overdosage:
If you or anyone else accidentally takes too much of CLOKERAN 5MG TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are reversible pancytopenia (decrease in red, white blood cells and platelets) and neurological effects include agitated behaviour, ataxia (problems with coordination) and fits.
SYNOPSIS
| Drug | : | Chlorambucil |
| Pharmacological Category | : | Alkylating agents |
| Therapeutic Indication | : | Hodgkin's disease and Non-Hodgkin’s Lymphoma, Chronic lymphocytic leukaemia Waldenstrom's macroglobulinaemia |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep CLOKERAN 5MG TABLET out of reach in children
- Store CLOKERAN 5MG TABLET in a refrigerator (2 and 8°C)
FAQs ABOUT CLOKERAN 5MG TABLET
Can CLOKERAN 5MG TABLET cure cancer?
CLOKERAN 5MG TABLET is used to treat certain types of cancer of the blood and lymph nodes. This medicine doesn't cure cancer, but it helps relieve its symptoms. Contact your doctor for advice.
How long can you take CLOKERAN 5MG TABLET?
Take CLOKERAN 5MG TABLET according to the doctor’s advice. 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. Your doctor will advise you on how long you should continue to take CLOKERAN 5MG TABLET.
What if I forget to take a dose of CLOKERAN 5MG TABLET?
If you have missed a dose of CLOKERAN 5MG TABLET, take it as soon as you remember. But if it is almost time for your next dose, you can skip the missed dose and take the next scheduled dose. Do not take double dose to make up for your missed one as this may increase the chances of having side effects.
Does CLOKERAN 5MG TABLET cause infertility?
Yes, CLOKERAN 5MG TABLET affects ovaries or sperm, which may lead to infertility (inability to have a baby). In woman menstruation can stop (amenorrhoea) and in men, lack of sperm count can be observed (azoospermia). Contact your doctor for advice.
Is CLOKERAN 5MG TABLET safe in pregnancy?
CLOKERAN 5MG TABLET is not recommended for use in pregnant women or are planning for pregnancy because it may cause permanent damage to a foetus. Women of childbearing potential should be advised to use a reliable form of contraception to avoid becoming pregnant if either you or your partner is taking CLOKERAN 5MG TABLET.
Does CLOKERAN 5MG TABLET cause cancer?
It is possible that the use of this medicine particularly long-term use, may increase the risk of developing a secondary blood cancer. In many cases, patients who develop this have also received another type of chemotherapy or some form of radiation therapy. Symptoms of a secondary blood cancer include tiredness, fever, infection and bruising. Talk to your doctor immediately if you have any of these symptoms.
Can CLOKERAN 5MG TABLET be taken with food?
Take CLOKERAN 5MG TABLET as advised by your physician. CLOKERAN 5MG TABLET should be taken daily on an empty stomach (at least one hour before meals or three hours after meals). Swallow the medicine with a glass of water and do not chew or crush the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
Does CLOKERAN 5MG TABLET cause fits?
Yes, CLOKERAN 5MG TABLET may cause fits particularly in patients who have ever had fits or convulsions are at more risk of having fits when taking this medicine. Contact your doctor before taking it.
REFERENCES
1. K.D Tripathi. Anticancer Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 860.
2. Bethesda (MD). Chlorambucil. NIH National Library of Medicine, National Center for Biotechnology Information. PubChem Compound Summary. 2004. [Accessed on 17th December 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Chlorambucil
3. Bethesda (MD). Chlorambucil. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases. October 2017. [Accessed on 17th December 2022] https://www.ncbi.nlm.nih.gov/books/NBK548207/
4. EXCELLA GmbH & Co. KG. Electronic Medicines Compendium (EMC). [Revised in January 2017] [Accessed on 17th December 2022] https://www.medicines.org.uk/emc/files/pil.4656.pdf
5. EXCELLA GmbH & Co. KG. Health Products Regulatory Authority (HPRA). [Revised in January 2017] [Accessed on 17th December 2022] https://www.hpra.ie/img/uploaded/swedocuments/81f366e9-a0db-4d3b-b669-bb18ea255878.pdf
6. Chlorambucil tablet. DailyMed: National Library of Medicine: National Institute of Health. [Revised in August 2022] [Accessed on 17th December 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=967ed3ff-d99b-41e8-b768-dfb586d3d9a6
7. Celkeran Tablet (Chlorambucil 2mg, 5mg). Celon Laboratories Ltd. [Accessed on 17th December 2022] https://celonlabs.com/oncology-vivilon/
8. Drug bank. Chlorambucil. [Accessed on 17th December 2022] https://go.drugbank.com/drugs/DB00291
USEFUL DIAGNOSTIC TESTS
- Complete blood count
- Liver function test
PRODUCT DETAILS
ALTERNATE BRANDS
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