Chlorambucil 5mg tablets
A nitrogen mustard alkylating agent used as antineoplastic agent for the treatment of various malignant and nonmalignant diseases.
Official documents, adverse reaction reporting, and safety monitoring
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Official medicine documents
Safety monitoring data
Yellow Card reports
The MHRA Yellow Card scheme collects reports of suspected side effects from healthcare professionals and patients. View the Drug Analysis Profile (iDAP) for real-world adverse reaction data.
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Suspected adverse reactions reported for Chlorambucil
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
The European Medicines Agency (EMA) collects suspected adverse reaction reports from across the EU/EEA through the EudraVigilance system. Search for safety data on this medicine.
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Suspected adverse reactions reported for Chlorambucil
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
1 branded products available
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(13)
Obinutuzumab in combination with chlorambucil for untreated chronic lymphocytic leukaemia (TA343)
Bendamustine for the first-line treatment of chronic lymphocytic leukaemia (TA216)
Rituximab for the first-line treatment of chronic lymphocytic leukaemia (TA174)
Fludarabine monotherapy for the first-line treatment of chronic lymphocytic leukaemia (TA119)
Acalabrutinib for treating chronic lymphocytic leukaemia (TA689)
Rituximab for the first-line treatment of stage III-IV follicular lymphoma (TA243)
Idelalisib for treating chronic lymphocytic leukaemia (TA359)
Zanubrutinib for treating Waldenstrom's macroglobulinaemia (TA833)
Ibrutinib with venetoclax for untreated chronic lymphocytic leukaemia (TA891)
Non-Hodgkin lymphoma: diagnosis and management (NG52)
Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia (TA193)
Zanubrutinib for treating chronic lymphocytic leukaemia (TA931)
Obinutuzumab with bendamustine for treating follicular lymphoma after rituximab (TA629)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
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Supply & safety information
Official UK regulator monitoring and safety alerts
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. Shortage and safety information sourced from MHRA drug safety updates (gov.uk, Crown Copyright under OGL v3.0).
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing all 27 studies.
Reviews & meta-analyses: 1 · Randomised trials: 6 · 1973–2026
Showing all 27 studies, sorted by most relevant.
J. Sharman, M. Egyed, W. Jurczak, et al.
Lancet (London, England), 2020
- Antineoplastic Agents, Immunological
- Agammaglobulinaemia Tyrosine Kinase
- Progression-Free Survival
C. Moreno, R. Greil, F. Demirkan, et al.
The Lancet. Oncology, 2019
- Progression-Free Survival
- Adenine
- Antineoplastic Combined Chemotherapy Protocols
O. Al‐Sawaf, Can Zhang, M. Tandon, et al.
The Lancet. Oncology, 2020
- Progression-Free Survival
- Antineoplastic Combined Chemotherapy Protocols
- Chlorambucil
E. Zucca, A. Conconi, G. Martinelli, et al.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017
- Rituximab
- Antineoplastic Combined Chemotherapy Protocols
- Chlorambucil
C. Niemann, T. Munir, C. Moreno, et al.
The Lancet. Oncology, 2023
- Adenine
- Antineoplastic Combined Chemotherapy Protocols
- Chlorambucil
C. Moreno, R. Greil, F. Demirkan, et al.
Haematologica, 2022
- Chlorambucil
- Leukemia, Lymphocytic, Chronic, B-Cell
- Adenine
iLLUMINATE is a randomized, open-label phase III study of ibrutinib plus obinutuzumab (n=113) versus chlorambucil plus obinutuzumab (n=116) as first-line therapy for patients with chronic lymphocytic leukemia or small lymphocytic lymphoma. Eligible patients were aged ≥65 years, or <65 years with coexisting conditions. Patients received oral ibrutinib 420 mg once daily until disease progression or unacceptable toxicity or six cycles of oral chlorambucil, each in combination with six cycles of intravenous obinutuzumab. After a median follow-up of 45 months (range, 0.2-52), median progression-free survival continued to be significantly longer in the ibrutinib plus obinutuzumab arm than in the chlorambucil plus obinutuzumab arm (median not reached versus 22 months; hazard ratio=0.25; 95% confidence interval: 0.16-0.39; P<0.0001). The best overall rate of undetectable minimal residual disease (<0.01% by flow cytometry) remained higher with ibrutinib plus obinutuzumab (38%) than with chlorambucil plus obinutuzumab (25%). With a median treatment duration of 42 months, 13 months longer than the primary analysis, no new safety signals were identified for ibrutinib. As is typical for ibrutinib-based regimens, common grade ≥3 adverse events were most prevalent in the first 6 months of ibrutinib plus obinutuzumab treatment and generally decreased over time, except for hypertension. In this final analysis with up to 52 months of follow-up (median 45 months), ibrutinib plus obinutuzumab showed sustained clinical benefit, in terms of progression- free survival, in first-line treatment of chronic lymphocytic leukemia, including in patients with high-risk features. ClinicalTrials.gov identifier: NCT02264574.
Abstract licence: CC BY-NC
V. Goede, K. Fischer, R. Busch, et al.
The New England journal of medicine, 2014
- Rituximab
- Antineoplastic Combined Chemotherapy Protocols
- Chlorambucil
J. Sharman, M. Egyed, W. Jurczak, et al.
Leukemia, 2022
- Leukemia, Lymphocytic, Chronic, B-Cell
- Antineoplastic Combined Chemotherapy Protocols
- Benzamides
Bruton tyrosine kinase (BTK) inhibitors have improved chronic lymphocytic leukemia (CLL) outcomes and offer a chemotherapyfree option The BTK inhibitor ibrutinib, alone or with a CD20 antibody, demonstrated better efficacy versus chemoimmunotherapy in treatment-nave (TN) CLL However, cardiovascular toxicity is a concern with continuous ibrutinib use
Abstract licence: CC BY
C. Herling, Marion Klaumünzer, Cristiano Krings Rocha, et al.
Blood, 2016
- Leukemia, Lymphocytic, Chronic, B-Cell
- Abnormal Karyotype
- Rituximab
K. Viviano
The Veterinary clinics of North America. Small animal practice, 2022
- Cat Diseases
- Dog Diseases
- Drug-Related Side Effects and Adverse Reactions
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
1.5 hours
Mechanism
Alkylating agents work by three different mechanisms: 1) attachment of alkyl gro…
Food interactions
3 warnings
Human targets
1 target
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Half-life
1.5 hours
Protein binding
99%
Elimination
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 621 interactions
How the body processes this drug — absorption, distribution, metabolism, and elimination
Enzymes involved in drug metabolism — important for understanding drug interactions
Proteins that transport this drug across cell membranes
PMID:19129463 PMID:7557095
Responsible for intestinal absorption of bile acids (By similarity). Transports dehydroepiandrosterone 3-sulfate (DHEAS), a major circulating steroid secreted by the adrenal cortex, as well as estrone 3-sulfate and 17beta-estradiol 17-O-(beta-D-glucuronate) .
PMID:11159893 PMID:12568656 PMID:19129463 PMID:23918469 PMID:25560245 PMID:9539145
Mediates apical uptake of all-trans-retinol (atROL) across human retinal pigment epithelium, which is essential to maintaining the integrity of the visual cycle and thus vision .
PMID:25560245
Involved in the uptake of clinically used drugs .
PMID:17301733 PMID:20686826 PMID:27777271
Capable of thyroid hormone transport (both T3 or 3,3',5'-triiodo-L-thyronine, and T4 or L-tyroxine) .
PMID:19129463 PMID:20358049
Also transports prostaglandin E2 .
PMID:19129463
Plays roles in blood-brain and -cerebrospinal fluid barrier transport of organic anions and signal mediators, and in hormone uptake by neural cells (By similarity). May also play a role in the reuptake of neuropeptides such as substance P/TAC1 and vasoactive intestinal peptide/VIP released from retinal neurons .
PMID:25132355
May play an important role in plasma and tissue distribution of the structurally diverse chemotherapeutic drugs methotrexate and paclitaxel .
PMID:23243220
Shows a pH-sensitive substrate specificity which may be ascribed to the protonation state of the binding site and leads to a stimulation of substrate transport in an acidic microenvironment .
PMID:19129463
Hydrogencarbonate/HCO3(-) acts as the probable counteranion that exchanges for organic anions .
PMID:19129463
May contribute to regulate the transport of organic compounds in testis across the blood-testis-barrier (Probable)
ATC L01AA02
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Chlorambucil
Additional database identifiers
Drugs Product Database (DPD)
10153
ChemSpider
2607
BindingDB
50003677
PDB
CBL
ZINC
ZINC000000001115
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4638
GenAtlas
GSTP1
GeneCards
GSTP1
GenBank Gene Database
M24485
GenBank Protein Database
31946
UniProt Accession
GSTP1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4626
GenAtlas
GSTA1
GeneCards
GSTA1
GenBank Gene Database
M15872
GenBank Protein Database
306809
UniProt Accession
GSTA1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4627
GenAtlas
GSTA2
GeneCards
GSTA2
GenBank Gene Database
M16594
GenBank Protein Database
306811
UniProt Accession
GSTA2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4632
GenAtlas
GSTM1
GeneCards
GSTM1
GenBank Gene Database
X08020
GenBank Protein Database
31924
UniProt Accession
GSTM1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4634
GenAtlas
GSTM2
GeneCards
GSTM2
GenBank Gene Database
M63509
GenBank Protein Database
183301
UniProt Accession
GSTM2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4635
GenAtlas
GSTM3
GeneCards
GSTM3
GenBank Gene Database
J05459
GenBank Protein Database
306820
UniProt Accession
GSTM3_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4636
GenAtlas
GSTM4
GeneCards
GSTM4
GenBank Gene Database
M96234
GenBank Protein Database
306819
UniProt Accession
GSTM4_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4637
GenAtlas
GSTM5
GeneCards
GSTM5
GenBank Gene Database
L02321
GenBank Protein Database
468260
UniProt Accession
GSTM5_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4638
GenAtlas
GSTP1
GeneCards
GSTP1
GenBank Gene Database
M24485
GenBank Protein Database
31946
UniProt Accession
GSTP1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4641
GenAtlas
GSTT1
GeneCards
GSTT1
GenBank Gene Database
X79389
GenBank Protein Database
510905
UniProt Accession
GSTT1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4642
GeneCards
GSTT2
UniProt Accession
GST2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:33437
GeneCards
GSTT2B
UniProt Accession
GSTT2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:17890
GeneCards
HPGDS
GenBank Gene Database
D82073
GenBank Protein Database
3046817
Guide to Pharmacology
1381
UniProt Accession
HPGDS_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:10956
GeneCards
SLCO1A2
GenBank Gene Database
U21943
GenBank Protein Database
885978
Guide to Pharmacology
1219
UniProt Accession
SO1A2_HUMAN
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q415939), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication.