Celkeran

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What Is Celkeran?

Celkeran is an oral tablet from Celon Laboratories containing chlorambucil. Chlorambucil is one of the oldest oral alkylating cytotoxic agents (nitrogen mustard derivative, in clinical use since the 1950s). It is gentle, well-tolerated, and remains relevant for older or frail patients with chronic lymphocytic leukaemia or low-grade lymphoma who cannot tolerate more intensive chemoimmunotherapy.

Použití a indikace

• Chronic lymphocytic leukaemia (CLL) — older or frail patients, often combined with rituximab or obinutuzumab
• Low-grade non-Hodgkin lymphoma (follicular, marginal zone)
• Waldenström macroglobulinaemia
• Advanced Hodgkin lymphoma (older MOPP / ChlVPP regimens)
• Mimo indikaci: nephrotic syndrome (steroid-resistant minimal change), behçet's disease

Dosage and How to Take

• Continuous low-dose: 0.1–0.2 mg/kg/day
• Intermittent pulse: 0.4–0.8 mg/kg every 2–4 weeks
• Combined with anti-CD20 antibody: standard CLL induction regimen

1. Take on an empty stomach — 1 hour before food — for consistent absorption.
2. Same time each day. Swallow whole.
3. Mandatory monitoring: FBC every 1–2 weeks during active treatment. Be aware: nadir is delayed (3–4 weeks after dose), recovery slow (4–6 weeks). LFTs monthly.
4. Hold or reduce dose for ANC < 1,500/µL or platelets < 100,000/µL.
5. Caregivers handling tablets should wear gloves.

Vedlejší účinky

Časté: myelosuppression (delayed-onset, prolonged), nausea, mild anorexia.

Důležité:

• Severe pancytopenia at higher cumulative doses
• Permanent infertility (gonadotoxic)
• Secondary leukaemia / myelodysplastic syndrome (long-term cumulative-dose risk)
• Hepatotoxicity (rare)
• Severe skin reactions (rare)
• Seizures (very rare, usually high-dose)

Varování

• Pregnancy: teratogenic; strict contraception throughout treatment + 6 months after.
• Breastfeeding: avoid.
• Live vaccines: contraindicated.
• Recent / active infection: treat before starting; hold during serious infection.
• Renal / hepatic impairment: dose reduction.
• Caregiver gloves when handling tablets.

Interakce s léčivy

Skladování

• Refrigerate at 2–8°C — chlorambucil tablets are temperature-sensitive.
• Out of reach of children, women of childbearing potential, and pets.
• Caregivers wear gloves.

Související alternativy na MedsBase

Other oncology medications stocked alongside this product:

• Endoxan (cyclophosphamide 50 mg)
• Temotero (temozolomide 20 / 100 mg)
• Temozol (temozolomide 20 mg)
• Lomoother (lomustine 40 mg)
• Endace (megestrol 40 / 160 mg)

Browse all anti-cancer medications →

Často kladené dotazy

Why is Celkeran still used in 2026 when there are newer CLL drugs?

Modern CLL therapy emphasises BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib) and venetoclax + obinutuzumab for fit patients. Chlorambucil retains a role for older or frail patients who cannot tolerate intensive chemoimmunotherapy or targeted therapy — particularly in combination with obinutuzumab (CLL11 trial). Cost-effectiveness and tolerability are the main reasons it persists.

Why must I refrigerate Celkeran?

Chlorambucil tablets are heat-sensitive and degrade over time at room temperature, especially in warmer climates. Refrigeration (2–8°C) preserves potency. Keep in original blister, away from food, out of reach of children, women of childbearing potential, and pets.

Why is the FBC nadir delayed?

Chlorambucil is one of the slowest-acting alkylating agents. Marrow nadir typically occurs 3–4 weeks after dose and recovery takes another 4–6 weeks. This means cumulative myelosuppression can sneak up on patients on continuous dosing — FBC monitoring every 1–2 weeks is essential during active treatment.

Will Celkeran affect my fertility?

Yes — chlorambucil is gonadotoxic and may cause permanent infertility. Discuss fertility preservation (sperm banking, oocyte cryopreservation) before starting in any reproductive-age patient.

What about secondary leukaemia risk?

Long-term high-cumulative-dose chlorambucil exposure carries a small but real risk of secondary myelodysplastic syndrome and acute leukaemia — mainly with cumulative doses above 1.3 g. Modern regimens limit total exposure to mitigate this.

Is Celkeran safe in pregnancy?

No — teratogenic. Strict contraception throughout treatment and for 6 months after the last dose, in both male and female patients. Discuss family planning before starting.

Can I have live vaccines?

No — live vaccines (MMR, yellow fever, BCG, oral polio, varicella) are contraindicated during chlorambucil therapy and for several months after. Inactivated vaccines are safe and recommended.

Caregivers handling Celkeran — precautions?

Yes — tablets are cytotoxic. Caregivers should wear gloves when handling, wash hands afterwards. Pregnant caregivers should avoid handling chlorambucil entirely.

Proč objednávat z MedsBase

Každá šarže je dodávána od výrobce certifikovaného WHO-GMP. Objednávky jsou expedovány v nenápadných obalech bez loga od našich partnerských skladů a jsou pokryty naší Zárukou opětovného odeslání: pokud zásilka nedorazí do 20 pracovních dnů, zašleme zdarma náhradní zásilku, bez dotazů.

Related Anti-Cancer Medications

Other oncology medications stocked alongside this product:

• Endoxan (cyclophosphamide 50 mg)
• Lomoother (lomustine 40 mg)
• Imatib (imatinib 100/400 mg)
• Veenat (imatinib 100/400 mg)
• Hydrosar (hydroxyurea 500 mg)

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