Chlorambucil Leukeran

Action

Alkylating agent. Interferes with cell function and mitotic activity by inhibition of intracellular macromolecules.

Selected Indications Severe RA, SLE, vasculitis.

Metabolism

Adequate and reliable oral absorption. Incomplete information concerning metabolism and excretion. Adverse Reactions

Myelosuppression is usually moderate, gradual, and rapidly reversible. Gastrointestinal discomfort, dermatitis, and hepatotoxicity occasionally occur. Caution

Frequent complete blood cell counts should be obtained. Delayed occurrence of acute leukemia is reported. Infertility in both sexes may occur. Supply

Tablets, 2 mg. Dosage

The dosage is 0.05 to 0.2 mg/kg daily. The total daily dose (usually 4 to 10 mg) is given as a single dose. Chloroquine (Aralen)

Action

Mode of action is unknown. Potential actions include binding of nucleic acids, stabilization of lysosomal membranes, and trapping of free radicals.

Selected Indications RA, SLE, cutaneous LE.

Metabolism

Chloroquine is well absorbed from the gastrointestinal tract. The drug is concentrated and retained in body tissues. Peak plasma concentrations are attained within 2 hours, which may be facilitated by administering the drug with food. Chloroquine and its metabolites are slowly excreted by the kidneys. Unabsorbed drug is eliminated in the feces.

Adverse Reactions

The most common side effects are allergic eruptions and gastrointestinal disturbances (anorexia, nausea, cramps, diarrhea). The most serious complication is ocular toxicity, which appears to be dose-dependent but more common than with hydroxychloroquine. Reversible corneal deposits of the drug are detectable by slit-lamp examination, but retinopathy affecting macular pigmentation may be irreversible. Less common side effects include hyperpigmented rash, hypopigmentation of hair, neuropathy, ototoxicity, and cardiomyopathy. Hematologic toxicity is rare.

Caution

Ophthalmologic examination (color testing, visual fields, funduscopy, slit-lamp examination) should be performed every 4 to 6 months. Complete blood cell count should be performed periodically. At the first sign of visual disturbance, the drug should be discontinued. Hydroxychloroquine may cause hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency. The drug is contraindicated in patients with significant visual, hepatic, or renal impairment, or porphyria, and during pregnancy.

Supply

Tablets, 300 mg. Dosage

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Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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