What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

blood disorders

head injury

nfection (especially a virus infection such as chickenpox, cold sores, or herpes)

recent or ongoing radiation therapy

seizures

an unusual or allergic reaction to chlorambucil, other chemotherapy, other medicines, foods, dyes, or preservatives

pregnant or trying to get pregnant

breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is less than four hours to your next dose, take only that dose and skip the missed dose. Do not take double or extra doses.

What may interact with this medicine?

This medicine may also interact with the following medications:

nalidixic acid

medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim

vaccines

Talk to your doctor or health care professional before taking any of these medicines:

acetaminophen

aspirin

buprofen

ketoprofen

naproxen

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.
In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.
Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.
This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.
Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.
Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.
Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.
Men should inform their doctor if they wish to father a child. This medicine may lower sperm counts.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine

signs of decreased red blood cells - unusually weak or tired, fainting spells, lightheadedness

agitation

breathing problems

confusion

cough that does not go away

dark urine

hallucinations

mouth sores

redness, blistering, peeling or loosening of the skin, including inside the mouth

seizures

tingling, pain or numbness in the hands or feet

tremors

trouble passing urine or change in the amount of urine

trouble with balance, walking

vomiting

yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

diarrhea

loss of appetite

missed menstrual periods

nausea

Where should I keep my medicine?

Keep out of the reach of children.
Store in the refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Protect from moisture and light. Throw away any unused medicine after the expiration date.