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Leukeran (Chlorambucil) Buyer and Patient Handbook in South Africa

What is Leukeran?

Leukeran is a chlorambucil-based oral chemotherapy pill used primarily to treat chronic lymphocytic leukaemia and certain types of Lymphoma. It belongs to the alkylating agent class, which works by attaching to DNA and preventing Cancer cells from multiplying. Leukeran is approved by the South African Health Products Regulatory Authority (SAHPRA) and is available in 2 mg and 5 mg tablet strengths.

Who Should Use Leukeran?

• Adults diagnosed with chronic lymphocytic leukaemia (CLL)
• Patients with low-grade non-Hodgkin lymphoma where an alkylating agent is indicated
• Individuals who have been evaluated by a qualified oncology professional and found suitable for oral chemotherapy

How Does It Work?

Leukeran releases chlorambucil, an alkylating compound that forms covalent bonds with DNA strands, disrupting the replication process of malignant lymphocytes. By halting cell division, it reduces tumour burden and helps restore normal blood counts. The medication is taken at home, allowing patients to continue daily activities such as work or light exercise while treatment proceeds.

Why Choose Leukeran?

• Proven efficacy in CLL and selected lymphomas with long-term safety data.
• Convenient oral dosing eliminates the need for frequent intravenous visits.
• Cost-effective compared with many newer targeted agents, while still delivering reliable results. (Use of Leukeran for unapproved conditions should only be considered after specialist consultation.)

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• 2 mg tablet: typically prescribed once daily.
• 5 mg tablet: may be used alone or in combination to reach the total daily dose advised by the treating oncologist.

How to Take

1. Swallow the tablet whole with a full glass of water.
2. Take it at the same time each day, preferably with food to minimise stomach irritation.

Missed Dose

If you forget a dose, take it as soon as you remember provided it is at least 6 hours before the next scheduled dose. Otherwise, skip the missed tablet and resume your regular schedule-do not double-dose.

Overdose

In case of suspected overdose, seek immediate medical attention (call 10177 or go to the nearest emergency department). Provide the amount taken and the time of ingestion.

Special Populations

• Elderly: Start with the lower 2 mg dose and monitor blood counts closely.
• Renal impairment: Dose reduction may be required; consult the prescribing oncologist.
• Pregnancy & breastfeeding: Contraindicated due to teratogenic risk; use effective contraception.

Lifestyle & Diet

• Avoid grapefruit or grapefruit juice as they may increase chlorambucil levels.
• Limit alcohol intake, which can exacerbate bone-marrow suppression.
• Maintain adequate hydration and a balanced diet to support overall health.

Precautions and Warnings

• Monitor complete blood counts weekly during the first month, then as advised.
• Watch for signs of infection (fever, sore throat) and report promptly.
• Protective gloves should be worn when handling tablets to limit skin exposure.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea or mild vomiting
• Fatigue or weakness
• Low white-blood-cell count (leukopenia)

Less Common Side Effects

• Hair thinning
• Mild rash or itching
• Mild liver enzyme elevation

Serious Side Effects

• Persistent fever or chills (possible infection) - seek medical care immediately
• Unexplained bruising or bleeding - contact a health professional
• Severe Nausea/Vomiting with inability to keep fluids down - seek urgent advice

Who Should Avoid This Medication?

• Individuals with known hypersensitivity to chlorambucil or any tablet component.
• Patients with severe bone-marrow failure (e.g., aplastic anemia).
• Pregnant or breastfeeding women.

Storage Instructions

• Store tablets at room temperature (15-30 °C), away from direct sunlight.
• Keep in a tightly closed container, out of reach of children.
• Do not refrigerate or freeze.

Leukeran Alternatives

Frequently Asked Questions

How long does treatment with Leukeran usually last?

Treatment duration varies; many patients take Leukeran continuously for months to years, based on disease response and blood-count monitoring.

Can I drink coffee while taking Leukeran?

Yes, moderate coffee consumption is safe, but avoid excessive caffeine that may worsen Insomnia or Anxiety.

Will Leukeran affect my ability to work?

Most patients maintain normal daily activities; however, fatigue may require occasional rest periods.

Is it safe to receive the flu vaccine while on Leukeran?

Live attenuated vaccines (e.g., nasal flu spray) are contraindicated, but inactivated flu shots are generally safe-confirm with your oncology team.

What should I do if I experience severe nausea?

Contact your healthcare provider; anti-emetic medication can often be prescribed to control symptoms.

Can I travel while on Leukeran?

Yes, but plan ahead: schedule blood-count checks before and after travel, and carry a copy of your medication record.

How often should my blood be tested?

Initially weekly, then every 2-4 weeks once stable; your oncologist will set a precise schedule.

Are there any food restrictions besides grapefruit?

No major restrictions, but a balanced diet supports recovery; avoid excessive alcohol.

Glossary

• Alkylating agent: A drug that adds an alkyl group to DNA, preventing cancer cells from dividing.
• Leukopenia: Reduced white-blood-cell count, increasing infection risk.
• CYP2C9: Liver enzyme that metabolises many medicines; inhibitors can raise drug levels.

Disclaimer

The information provided here is for general education only and does not replace professional medical advice. Off-label use of Leukeran should only be considered after a qualified specialist’s evaluation. Readers are responsible for verifying the suitability of this medication for their personal health situation. Our online pharmacy service offers convenient ordering and delivery of SAHPRA-approved medicines; however, all purchases are subject to local regulations and require a valid prescription from an authorised healthcare provider. Always consult your doctor or pharmacist before starting or changing any medication.