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Alkylating Agents for Chemotherapy


Generic NameBrand Name
bendamustineTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
busulfanTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
carboplatinTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
chlorambucilTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
cisplatinTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
cyclophosphamideTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
ifosfamideTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin
oxaliplatinTreanda, Busulfex, Myleran, Leukeran, Cytoxan, Ifex, Eloxatin

How It Works

These chemotherapy medicines are classified as alkylating agents. Alkylating agents are medicines that directly damage the DNA inside cancer cells. This prevents the cancer cells from multiplying.

Why It Is Used

These chemotherapy medicines are used to treat cancer. For example, bendamustine, busulfan, chlorambucil, and cyclophosphamide are used to treat leukemia. Carboplatin, cisplatin, and oxaliplatin are used to treat other cancers, such as bladder, colorectal, endometrial, lung, ovarian, and testicular cancer. Cyclophosphamide is also used to treat many other forms of cancer, such as breast cancer, multiple myeloma, non-Hodgkin's lymphoma, and sarcoma.

How Well It Works

These medicines work well in treating cancer. But the type and extent of a cancer affects how well this medicine slows or stops the growth of those cancer cells.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Callor other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Passed out (or lost consciousness).

Call your doctor right away if you have:

  • Hives.
  • Unusual bleeding from your nose, mouth, vagina, or rectum.
  • Blood in your urine, frequent urination, or painful urination.
  • Fever or chills with or without cough, hoarseness, or lower back or side pain.
  • Strong feelings of restlessness, confusion, or you are seeing, hearing, or feeling things that are not there.
  • Unusual tiredness or dizziness.
  • Redness, swelling, or pain at the place where this medicine was injected.
  • Numbness, burning, and tingling in the hands or feet (peripheral neuropathy). To prevent permanent nerve damage, you may need to have a lower dosage, stop using this medicine, or switch to a different medicine.

Alkylating agents can cause long-term damage to the bone marrow. In rare cases, people with cancer who are treated with these medicines can get leukemia years later. But carboplatin, cisplatin, and oxaliplatin (also called the platinum drugs) are less likely than the other alkylating agents to cause leukemia.

Common side effects of these medicines include:

These medicines may also cause:

  • Menstrual changes, symptoms of menopause (hot flashes and vaginal dryness), or early menopause in women.
  • Decreased sperm counts in men.
  • Low blood counts, which may make you tired and more likely to get an infection.

Busulfan can cause pulmonary fibrosis and other serious problems in the lungs.

Cisplatin and oxaliplatin may cause:

  • Ear problems (ototoxicity), which may not get better. This includes ringing in the ears (tinnitus), hearing loss, and vertigo.
  • Eye problems, such as blurred vision or loss of the ability to see colors.
  • Kidney damage, which may or may not get better. Keeping plenty of fluids in the body during treatment may be helpful.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

You may not be able to become pregnant or father a child after taking these medicines. Discuss this with your doctor before starting treatment with any of these medicines.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerBrian Leber, MDCM, FRCPC - Hematology
Last RevisedDecember 12, 2012

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