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Celkeran

✅ Treats leukemia
✅ Suppresses cancer growth
✅ Controls lymphoma symptoms
✅ Improves survival rates
✅ Manages autoimmune diseases

Celkeran contains Chlorambucil.

Medicinsk gennemgået af Morgan Ellis — Apoteksforsker · 8 års erfaring  · Sidst gennemgået: maj 2026

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⚡ Quick Answer — What is Celkeran?

Celkeran is an oral tablet from Celon Laboratories containing chlorambucil2 mg or 5 mg strengths — a slow-acting oral alkylating cytotoxic agent of the nitrogen mustard family. Used for chronic lymphocytic leukaemia (CLL), low-grade non-Hodgkin lymphoma, Waldenström macroglobulinaemia og advanced Hodgkin lymphoma (older regimens). Standard adult dose: 0.1–0.2 mg/kg/day continuous or 0.4–0.8 mg/kg every 2 weeks (intermittent). Take on an empty stomach (1 hour before food) for consistent absorption. Mandatory monitoring: FBC every 1–2 weeks — chlorambucil produces slow-onset, prolonged myelosuppression with delayed nadir. Pregnancy contraindication; gonadotoxicity (offer fertility preservation in reproductive-age patients).

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⚠ Specialist supervision required. Cancer medications must be prescribed by a treating oncologist with a confirmed diagnosis, baseline staging, and a defined treatment plan. Never start, stop, change dose, or use cancer medication outside of an oncology-led care plan. Most cancer drugs require regular blood-test monitoring (FBC, LFT, renal function), are absolutely contraindicated in pregnancy, and have significant drug interactions.
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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.

— det forstærker den normale fysiologiske respons snarere end at udløse en kunstigt.

  • 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)
  • Off-label: 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.

Bivirkninger

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

Vigtigt:

  • 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)

Advarsler

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

Lægemiddelinteraktioner

Kombiner medEffektHvad skal der gøres
Other myelosuppressive drugsAdditive marrow toxicitySpecialist supervision.
Live vaccinesDisseminated infectionContraindicated.
Allopurinol (for hyperuricaemia from cell turnover)Compatible — standard supportive careOften co-prescribed.

Opbevaring

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

Relaterede alternativer på MedsBase

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Ofte stillede spørgsmål

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.

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Other oncology medications stocked alongside this product:

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Styrke

2 mg, 5 mg

Antal

30 tablet(ter), 60 tablet(ter), 90 tablet(ter)

Farmaceutisk form

Tablet/s

Producent

Celon Laboratories

Behandling

Blood cancer, Hodgkin’s disease

Generisk mærke

Chlorambucil

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