Uses
Celkeran 2 (Chlorambucil) is an antitumor drug used to treat lymphogranulomatosis, non-Hodgkin`s lymphoma (lympho- and reticulosarcoma), chronic lymphatic leukemia, myeloma, Waldenstrom macroglobulinemia, Labretare-Sive`s disease, ovarian cancer, breast cancer, nephrotic syndrome. Repat binds to nucleoproteins of cell nuclei. It affects DNA chains by alkylation through the formation of highly active ethyleneimonium radicals, causes cross-linking or breaking of DNA strands and disrupts their replication. To a lesser extent, alters the synthesis of RNA. It inhibits the tumor and hematopoietic tissue. It acts more selectively on lymphoid tissue than on granulocyte elements. The clinical effect appears in 3-4 weeks. In some patients, during treatment for the first 2 years, the total number of blood leukocytes is normalized, the relative content of lymphocytes in the bone marrow is 20%, splenomegaly is eliminated, and enlarged lymph nodes are reduced. The maximum tolerated dose is 400 mg / m2. Dose-dependent and irreversible (with prolonged treatment, as well as when used in prepubertal age) inhibits the function of the gonads, causing amenorrhea or azoospermia.

Dosage and Administration
Always follow your doctor`s instructions when using Celkeran 2 (Chlorambucil) to get the safest and most effective results from treatment. The dosage is prescribed by the doctor individually for each patient. It depends on many factors, such as type of pathology, functioning of the liver, patient`s age.

Side effects
The use of Celkeran 2 (Chlorambucil) may cause side effects in some patients including:

• nausea, vomiting, diarrhea, gastrointestinal bleeding
• mielodepressiya (leukopenia, thrombocytopenia, anemia, lymphopenia)
• cough, shortness of breath
• painful, difficult urination, hematuria
• tremor, muscle tremors, agitation, disturbance of consciousness, ataxia, peripheral neuropathy
• erythema multiforme, toxic epidermal necrosis
• pain syndrome (pain in the back, joints), the development of infections

Precautions
Celkeran 2 (Chlorambucil) is contraindicated for use in bone marrow hypoplasia (marked leukopenia, thrombocytopenia), epilepsy, renal failure, severe abnormal liver function hypersensitivity to Chlorambucil, incl. to other alkylating drugs.