Details of the Drug

General Information of Drug (ID: DMRKE63)

Drug Name

Chlorambucil

Synonyms

Ambochlorin; Amboclorin; Chlocambucil; Chloorambucol; Chlorambucilum; Chloraminophen; Chloraminophene; Chlorbutin; Chlorbutine; Chlorbutinum; Chloroambucil; Chlorobutin; Chlorobutine; Clorambucile; Clorambucilo; Ecloril; Elcoril; Elcorin; Leukeran; Leukersan; Leukoran; Linfolizin; Linfolysin; Lympholysin; Clorambucile [DCIT]; Glaxo Wellcome Brand of Chlorambucil; GlaxoSmithKline Brand of Chlorambucil; Leuk ersan; Leukeran tablets; Phenylbutyric acid nitrogen mustard; Wellcome Brand of Chlorambucil; C0253; CB 1348; CB1348; Cb l348; CB-1348; Chlorambucil [INN:BAN]; Chlorambucilum [INN-Latin]; Clorambucilo [INN-Spanish]; LEUKERAN (TN); Leukeran (TN); Phenylbuttersaeure-lost; Phenylbuttersaeure-lost[German]; Chlorambucil (USP/INN)

Indication

Disease Entry	ICD 11	Status	REF
Chronic lymphocytic leukaemia	2A82.0	Approved	[1]
Small lymphocytic lymphoma	2A82.0	Approved	[2]
Classic Hodgkin lymphoma	N.A.	Investigative	[2]
Follicular lymphoma	2A80	Investigative	[2]
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Therapeutic Class

Anticancer Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 0

Molecular Weight (mw)

304.2

Logarithm of the Partition Coefficient (xlogp)

1.7

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [3]
Bioavailability: 82% of drug becomes completely available to its intended biological destination(s) [4]
Clearance: The drug present in the plasma can be removed from the body at the rate of 2.8 mL/min/kg [5]
Elimination: 0.5% of drug is excreted from urine in the unchanged form [3]
Half-life: The concentration or amount of drug in body reduced by one-half in 1.5 hours [5]
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.65742 micromolar/kg/day [6]
Unbound Fraction: The unbound fraction of drug in plasma is 0.01% [5]
Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.26 L/kg [5]
Water Solubility: The ability of drug to dissolve in water is measured as 12 mg/mL [3]

Chemical Identifiers

Formula: C14H19Cl2NO2
IUPAC Name: 4-[4-[bis(2-chloroethyl)amino]phenyl]butanoic acid
Canonical SMILES: C1=CC(=CC=C1CCCC(=O)O)N(CCCl)CCCl
InChI: InChI=1S/C14H19Cl2NO2/c15-8-10-17(11-9-16)13-6-4-12(5-7-13)2-1-3-14(18)19/h4-7H,1-3,8-11H2,(H,18,19)
InChIKey: JCKYGMPEJWAADB-UHFFFAOYSA-N

Cross-matching ID

PubChem CID: 2708
ChEBI ID: CHEBI:28830
CAS Number: 305-03-3
DrugBank ID: DB00291
TTD ID: D0V8QT
VARIDT ID: DR00895
INTEDE ID: DR0297
ACDINA ID: D00119

Combinatorial Drugs (CBD)

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Repurposed Drugs (RPD)

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Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
DNA replication (DNA repli)	TTABD5E	NOUNIPROTAC	Intercalator	[7]

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Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
Organic anion transporting polypeptide 1A2 (SLCO1A2)	DTE2B1D	SO1A2_HUMAN	Substrate	[8]
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[9]

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Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Glutathione S-transferase pi (GSTP1)_{Main DME}	DEK6079	GSTP1_HUMAN	Substrate	[10]

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Drug Off-Target (DOT)

DOT Name	DOT ID	UniProt ID	Interaction	REF
14-3-3 protein sigma (SFN)	OTLJCZ1U	1433S_HUMAN	Gene/Protein Processing	[11]
Aldo-keto reductase family 1 member B10 (AKR1B10)	OTOA4HTH	AK1BA_HUMAN	Gene/Protein Processing	[12]
Aldo-keto reductase family 1 member C2 (AKR1C2)	OTQ2XMO3	AK1C2_HUMAN	Gene/Protein Processing	[12]
Apoptosis regulator BAX (BAX)	OTAW0V4V	BAX_HUMAN	Gene/Protein Processing	[13]
Apoptosis regulator Bcl-2 (BCL2)	OT9DVHC0	BCL2_HUMAN	Gene/Protein Processing	[14]
ATP-binding cassette sub-family C member 2 (ABCC2)	OTJSIGV5	MRP2_HUMAN	Regulation of Drug Effects	[15]
ATP-dependent translocase ABCB1 (ABCB1)	OTEJROBO	MDR1_HUMAN	Gene/Protein Processing	[16]
Baculoviral IAP repeat-containing protein 2 (BIRC2)	OTFXFREP	BIRC2_HUMAN	Drug Response	[17]
Baculoviral IAP repeat-containing protein 5 (BIRC5)	OTILXZYL	BIRC5_HUMAN	Gene/Protein Processing	[18]
Bcl-2-binding component 3, isoforms 3/4 (BBC3)	OTUAXDAY	BBC3B_HUMAN	Gene/Protein Processing	[18]

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Molecular Interaction Atlas (MIA)

MIA Detail

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Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Chlorambucil (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Roflumilast	DMPGHY8	Moderate	Additive immunosuppressive effects by the combination of Chlorambucil and Roflumilast.	Asthma [CA23]	[19]
Ofloxacin	DM0VQN3	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Ofloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Ciprofloxacin XR	DM2NLS9	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Ciprofloxacin XR.	Bacterial infection [1A00-1C4Z]	[20]
Trovafloxacin	DM6AN32	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Trovafloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Sparfloxacin	DMB4HCT	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Sparfloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Gemifloxacin	DMHT34O	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Gemifloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Norfloxacin	DMIZ6W2	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Norfloxacin.	Bacterial infection [1A00-1C4Z]	[20]
ABT-492	DMJFD2I	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by ABT-492.	Bacterial infection [1A00-1C4Z]	[20]
Levofloxacin	DMS60RB	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Levofloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Lomefloxacin	DMVRH9C	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Lomefloxacin.	Bacterial infection [1A00-1C4Z]	[20]
Grepafloxacin	DMGLX0T	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Grepafloxacin.	Bronchitis [CA20]	[20]
Amphotericin B	DMTAJQE	Moderate	Increased risk of nephrotoxicity by the combination of Chlorambucil and Amphotericin B.	Fungal infection [1F29-1F2F]	[21]
Teriflunomide	DMQ2FKJ	Major	Additive myelosuppressive effects by the combination of Chlorambucil and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[22]
Givosiran	DM5PFIJ	Moderate	Increased risk of nephrotoxicity by the combination of Chlorambucil and Givosiran.	Inborn porphyrin/heme metabolism error [5C58]	[21]
Denosumab	DMNI0KO	Moderate	Additive myelosuppressive effects by the combination of Chlorambucil and Denosumab.	Low bone mass disorder [FB83]	[23]
Thalidomide	DM70BU5	Major	Additive thrombogenic effects by the combination of Chlorambucil and Thalidomide.	Multiple myeloma [2A83]	[24]
Tecfidera	DM2OVDT	Moderate	Additive immunosuppressive effects by the combination of Chlorambucil and Tecfidera.	Multiple sclerosis [8A40]	[25]
Siponimod	DM2R86O	Major	Additive immunosuppressive effects by the combination of Chlorambucil and Siponimod.	Multiple sclerosis [8A40]	[21]
Fingolimod	DM5JVAN	Major	Additive immunosuppressive effects by the combination of Chlorambucil and Fingolimod.	Multiple sclerosis [8A40]	[26]
Ocrelizumab	DMEZ2KH	Moderate	Additive immunosuppressive effects by the combination of Chlorambucil and Ocrelizumab.	Multiple sclerosis [8A40]	[27]
Ozanimod	DMT6AM2	Major	Additive immunosuppressive effects by the combination of Chlorambucil and Ozanimod.	Multiple sclerosis [8A40]	[19]
Omacetaxine mepesuccinate	DMPU2WX	Moderate	Additive myelosuppressive effects by the combination of Chlorambucil and Omacetaxine mepesuccinate.	Myeloproliferative neoplasm [2A20]	[28]
Gatifloxacin	DMSL679	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[20]
Canakinumab	DM8HLO5	Moderate	Additive immunosuppressive effects by the combination of Chlorambucil and Canakinumab.	Rheumatoid arthritis [FA20]	[29]
Rilonacept	DMGLUQS	Moderate	Additive immunosuppressive effects by the combination of Chlorambucil and Rilonacept.	Rheumatoid arthritis [FA20]	[29]
Golimumab	DMHZV7X	Major	Additive immunosuppressive effects by the combination of Chlorambucil and Golimumab.	Rheumatoid arthritis [FA20]	[30]
Leflunomide	DMR8ONJ	Major	Additive immunosuppressive effects by the combination of Chlorambucil and Leflunomide.	Rheumatoid arthritis [FA20]	[22]
Anthrax vaccine	DM9GSWY	Moderate	Antagonize the effect of Chlorambucil when combined with Anthrax vaccine.	Sepsis [1G40-1G41]	[31]
Azathioprine	DMMZSXQ	Moderate	Additive myelosuppressive effects by the combination of Chlorambucil and Azathioprine.	Transplant rejection [NE84]	[21]
Cinoxacin	DM4EWNS	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Cinoxacin.	Urinary tract infection [GC08]	[20]
Plazomicin	DMKMBES	Moderate	Increased risk of nephrotoxicity by the combination of Chlorambucil and Plazomicin.	Urinary tract infection [GC08]	[21]
Enoxacin	DMYTE6L	Minor	Decreased absorption of Chlorambucil due to intestinal mucosa variation caused by Enoxacin.	Urinary tract infection [GC08]	[20]
Ganciclovir	DM1MBYQ	Moderate	Additive myelosuppressive effects by the combination of Chlorambucil and Ganciclovir.	Virus infection [1A24-1D9Z]	[21]
Valganciclovir	DMS2IUH	Moderate	Additive myelosuppressive effects by the combination of Chlorambucil and Valganciclovir.	Virus infection [1A24-1D9Z]	[21]
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Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Stearic acid	E00079	5281	Emulsifying agent; Solubilizing agent; Viscosity-controlling agent; lubricant
Beta-D-lactose	E00099	6134	Diluent; Dry powder inhaler carrier; Lyophilization aid
Eisenoxyd	E00585	56841934	Colorant
Ferric hydroxide oxide yellow	E00539	23320441	Colorant
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent
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⏷ Show the Full List of 6 Pharmaceutical Excipients of This Drug

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Chlorambucil 2 mg tablet	2 mg	Oral Tablet	Oral

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References

1	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7143).
2	Chlorambucil FDA Label
3	BDDCS applied to over 900 drugs
4	Critical Evaluation of Human Oral Bioavailability for Pharmaceutical Drugs by Using Various Cheminformatics Approaches
5	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
6	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
7	Roles of DNA repair and reductase activity in the cytotoxicity of the hypoxia-activated dinitrobenzamide mustard PR-104A. Mol Cancer Ther. 2009 Jun;8(6):1714-23.
8	Transporters and renal drug elimination. Annu Rev Pharmacol Toxicol. 2004;44:137-66.
9	Mammalian drug efflux transporters of the ATP binding cassette (ABC) family in multidrug resistance: A review of the past decade. Cancer Lett. 2016 Jan 1;370(1):153-64.
10	The anti-cancer drug chlorambucil as a substrate for the human polymorphic enzyme glutathione transferase P1-1: kinetic properties and crystallographic characterisation of allelic variants. J Mol Biol. 2008 Jun 27;380(1):131-44.
11	Differential effects of chemotherapeutic drugs versus the MDM-2 antagonist nutlin-3 on cell cycle progression and induction of apoptosis in SKW6.4 lymphoblastoid B-cells. J Cell Biochem. 2008 May 15;104(2):595-605. doi: 10.1002/jcb.21649.
12	Oxidative stress mechanisms do not discriminate between genotoxic and nongenotoxic liver carcinogens. Chem Res Toxicol. 2015 Aug 17;28(8):1636-46.
13	Bcl-2 antisense oligonucleotides enhance the cytotoxicity of chlorambucil in B-cell chronic lymphocytic leukaemia cells. Leuk Lymphoma. 2001 Jul;42(3):491-8. doi: 10.3109/10428190109064606.
14	Theophylline synergizes with chlorambucil in inducing apoptosis of B-chronic lymphocytic leukemia cells. Blood. 1996 Sep 15;88(6):2172-82.
15	Role of multidrug resistance protein 2 (MRP2, ABCC2) in alkylating agent detoxification: MRP2 potentiates glutathione S-transferase A1-1-mediated resistance to chlorambucil cytotoxicity. J Pharmacol Exp Ther. 2004 Jan;308(1):260-7. doi: 10.1124/jpet.103.057729. Epub 2003 Oct 20.
16	Enhanced in vitro invasiveness and drug resistance with altered gene expression patterns in a human lung carcinoma cell line after pulse selection with anticancer drugs. Int J Cancer. 2004 Sep 10;111(4):484-93. doi: 10.1002/ijc.20230.
17	Expression and prognostic significance of IAP-family genes in human cancers and myeloid leukemias. Clin Cancer Res. 2000 May;6(5):1796-803.
18	Differential gene expression induction by TRAIL in B chronic lymphocytic leukemia (B-CLL) cells showing high versus low levels of Zap-70. J Cell Physiol. 2007 Oct;213(1):229-36. doi: 10.1002/jcp.21116.
19	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
20	Johnson EJ, MacGowan AP, Potter MN, et al "Reduced absorption of oral ciprofloxacin after chemotherapy for haematological malignancy." J Antimicrob Chemother 25 (1990): 837-42. [PMID: 2373666]
21	Cerner Multum, Inc. "Australian Product Information.".
22	Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
23	Product Information. Prolia (denosumab). Amgen USA, Thousand Oaks, CA.
24	Bennett CL, Nebeker JR, Samore MH, et al "The Research on Adverse Drug Events and Reports (RADAR) project." JAMA 293 (2005): 2131-40. [PMID: 15870417]
25	Product Information. Vumerity (diroximel fumarate). Alkermes, Inc, Cambridge, MA.
26	Product Information. Gilenya (fingolimod). Novartis Pharmaceuticals, East Hanover, NJ.
27	Product Information. Ocrevus (ocrelizumab). Genentech, South San Francisco, CA.
28	Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
29	Product Information. Arcalyst (rilonacept). Regeneron Pharmaceuticals Inc, Tarrytown, NY.
30	Product Information. Cimzia (certolizumab). UCB Pharma Inc, Smyrna, GA.
31	CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18. [PMID: 20300058]