When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to chlorambucil or to similar cancer medicines, or if you are pregnant.

How to Use This Medicine:
Tablet

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• If you vomit after taking your medicine, call your doctor or pharmacist for instructions.
• Store this medicine in the refrigerator.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney or liver disease, bone marrow problems, a head injury, any type of infection, or a history of seizures.
• Tell your doctor if you had any other chemotherapy or radiation therapy within the past 4 weeks.
• This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
• Fever, chills, cough, sore throat, and body aches
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Painful or difficult urination
• Seizures or tremors
• Sores, ulcers, or white patches on your lips or mouth
• Uncontrollable muscle movements or twitching
• Unusual bleeding, bruising, or weakness
• Unusual lumps under your skin

If you notice these less serious side effects, talk with your doctor:

• Changes in your menstrual periods
• Confusion, agitation, or hallucination (seeing or hearing things that are not there)
• Mild nausea, vomiting, or diarrhea
• Mild skin rash

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088