• If you are allergic to anything, including medicines, dyes, additives, or foods.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.

• If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and options that may preserve your ability to have children.

• If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.

• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.

• If you have ever had seizures or a severe head injury.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.

Your doctor will probably test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

Stop the drug and tell your doctor or nurse right away if you develop signs of an allergic reaction such as rash, hives (itchy welts), fever and chills, or red blotches on your skin. If you have trouble breathing, if you have swelling or itching in your throat, lips, or mouth, or if you have other serious symptoms, stop the drug and get emergency help.

While taking this medicine, and for a few days afterward, there is a slight chance of a serious skin reaction. Symptoms often start as a skin rash with redness or blistering in the mouth, nose, or eyes, along with fever and body aches. If this happens, stop the drug and get emergency help.

Because of the way this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would likely be years after the drug is used. If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

• decreased white blood cell count with increased risk of infection*
• decreased platelet count with increased risk of bleeding*
• stopping of menstrual periods in women
• reduced sperm production in men
• fetal changes if pregnancy occurs while taking chlorambucil

• loss of appetite
• decreased weight
• sterility (inability to have children)

• nausea
• vomiting
• liver damage
• scarring of lung tissue*
• visual disturbances
• second cancer or leukemia*
• rash which can result in severe skin blistering*
• confusion
• seizures
• allergic reaction*