Doses - CHLORAMBUCIL

Dogs:

For adjunctive therapy (as an immunosuppressant) in the treatment of glomerulonephritis:0.1 - 0.2 mg/kg PO once daily or every other day. (Vaden and Grauer 1992)
For adjunctive therapy of lymphoreticular neoplasms, macroglobulinemia, and polycythemiavera: 2 - 6 mg/m2 PO once a day or every other day. (Jacobs, Lumsden et al. 1992)
For lymphoproliferative disease; macroglobulinemia: 2 - 4 mg/m2 PO q24 - 48h. (Gilsonand Page 1994)
For chronic lymphocytic leukemia: 20 mg/m2 PO every 1 -2 weeks or 6 mg/m2 PO daily.(Vail and Ogilvie 1994)
For treatment of pemphigus complex: Prednisone 2-4 mg/kg PO divided q12h with chlorambucil 0.2 mg/kg q24-48h. (Helton-Rhodes 1994)
Cats: For adjunctive immunosuppressive therapy in feline SLE: 0.25 - 0.5 mg/kg PO q48-72hours. (Thompson 1994)
For treatment of pemphigus complex: Prednisone 2-4 mg/kg PO divided q12h with chlorambucil 0.2 mg/kg q24-48h. (Helton-Rhodes 1994)
For adjunctive treatment of FIP: Predniso(lo)ne 4 mg/kg PO once daily with chlorambucil20 mg/m2 every 2-3 weeks. (Weiss 1994)
For chronic lymphocytic leukemia: Chlorambucil at 2 mg/m2 PO every other day or 20mg/m2 every other week; with or without prednisone at 20 mg/m2 PO every other day.
The authors state they have had more success with the high dose-every other weekregimen. (Peterson and Couto 1994a)

Horses:

For adjunctive therapy in treating lymphoma using the LAP protocol: Cytosine arabinoside200 - 300 mg/m2 SubQ or IM once every 1-2 weeks; Chlorambucil 20 mg/m2 POevery 2 weeks (alternating with cytosine arabinoside) and Prednisone 1.1 - 2.2 mg/kg
PO every other day. If this protocol is not effective (no response seen in 2-4 weeks) addvincristine at 0.5 mg/m2 IV once a week. Side effects are rare. (Couto 1994)
Monitoring Parameters - 1) Efficacy; 2) CBC, Platelets once weekly (or once stable every otherweek) during therapy; 3) Uric acid, liver enzymes; if warranted
Client Information - Clients must understand the importance of both administering chlorambucilas directed and to report immediately any signs associated with toxicity (e.g., abnormal bleeding, bruising, urination, depression, infection, shortness of breath, etc.).
Dosage Forms/Preparations/FDA Approval Status/Withholding Times - Veterinary-Approved Products: None

Human-Approved Products:

Chlorambucil Oral Tablets 2 mg; Leukeran® (Glaxo Wellcome); (Rx)