Labwork monitoring is strongly recommended while on Piroxicam and/or Chlorambucil. In the case of Piroxicam, we always watch for signs of GI bleeding and renal toxicity. With chlorambucil you must watch for bone marrow suppression which can happen over time. Patients can be fine for many months on these medications before side effects show up so diligent monitoring is recommended.
Piroxicam: CBC and chem/lytes recommended every 2 months long-term.
Chlorambucil: CBC at 2 weeks, then a 1 month, then every 2 months long-term.