Celkeran 2 mg (Chlorambucil): Complete Medical Guide – Uses, Dosage, Side Effects & Precautions

What is Celkeran?

Celkeran contains Chlorambucil, an alkylating agent used in chemotherapy. It works by interfering with the DNA of cancer cells, preventing their replication and leading to cell death. It is commonly prescribed to treat chronic lymphocytic leukemia (CLL), Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, and other hematologic malignancies.

✅ Indications / Uses:

Celkeran is used to treat the following cancers:

1. Chronic Lymphocytic Leukemia (CLL)
2. Hodgkin’s Lymphoma
3. Non-Hodgkin’s Lymphoma
4. Waldenström’s Macroglobulinemia
5. Other Lymphoproliferative Disorders

⚙️ Mechanism of Action:

Chlorambucil is an alkylating agent in the nitrogen mustard class. It works by:

• Attaching alkyl groups to DNA bases.
• Cross-linking DNA strands.
• Disrupting DNA replication and transcription.
• Inducing apoptosis (programmed cell death) in rapidly dividing cancer cells.

💊 Dosage and Administration:

Note: Always follow your oncologist or hematologist’s prescription.

General Guidelines:

• Chronic Lymphocytic Leukemia (CLL):
  • Usual starting dose: 0.1–0.2 mg/kg/day orally for 3–6 weeks.
• Lymphomas:
  • Initial dose: 0.1–0.2 mg/kg/day for several weeks; maintenance dosing varies.

Administration:

• Oral tablet, swallowed whole with water.
• Usually taken once daily.
• Should be taken on an empty stomach or as advised by your physician.

⚠️ Warnings and Precautions:

• Bone Marrow Suppression: Can lead to anemia, leukopenia, thrombocytopenia.
• Secondary Malignancies: Long-term use increases risk of leukemia.
• Fertility Effects: May cause permanent infertility in both men and women.
• Seizures: Rare but reported, particularly in high-dose regimens.
• Hepatotoxicity and Pulmonary Toxicity: Monitor liver and lung function.

❌ Contraindications:

• Known hypersensitivity to chlorambucil.
• Pregnancy (Category D – may cause fetal harm).
• Breastfeeding (drug is excreted in breast milk).
• Severe bone marrow suppression unless benefits outweigh risks.

🤰 Use in Pregnancy & Lactation:

• Pregnancy: Not safe. Can cause teratogenic effects and fetal harm.
• Lactation: Not recommended. Excreted in breast milk and may harm the infant.

🔬 Monitoring Parameters:

• Complete blood counts (CBC) – frequently during therapy.
• Liver function tests (LFTs)
• Renal function tests
• Pulmonary assessments if symptoms develop.
• Monitoring for infections or fever due to neutropenia.

⚠️ Possible Side Effects:

Common:

• Nausea, vomiting
• Bone marrow suppression
• Diarrhea
• Mouth ulcers
• Fatigue

Serious:

• Severe bone marrow failure
• Seizures
• Pulmonary fibrosis
• Hepatotoxicity
• Risk of secondary leukemia
• Severe infections

🧊 Storage:

• Store in a refrigerator (2–8°C).
• Protect from light and moisture.
• Keep out of reach of children.

📝 Patient Counseling Tips:

• Report any signs of fever, bleeding, bruising, or infections.
• Use effective contraception during and after treatment (up to 6 months).
• Avoid live vaccines during therapy.
• Do not handle the tablets with bare hands if you are not the patient.
• Adhere strictly to follow-up lab tests and appointments.