DBL Cytarabine

Cytarabine

Alone or in combination w/ other antineoplastic agents for remission induction & maintenance of AML in adulsts & childn. Acute lymphocytic leukaemia (ALL), blast phase chronic myeloid leukaemia (CML). Intrathecal administration in meningeal leukaemia.

Induction of remission in AML 200 mg/m² daily by continuous IV infusion over 24 hr for 5 days repeated approx every 2 wk. Intrathecal use in meningeal leukaemia 5-75 mg/m² once daily for 4 days to once every 4 days.

Hypersensitivity.

Anaphylactic reactions. Preexisting drug-induced bone marrow suppression. Increased risk of spinal cord toxicity if administered both intrathecal & IV w/in few days. Neurological reactions eg, headache to paralysis, coma & stroke-like episodes; induced hyperuricaemia secondary to rapid lysis of neoplastic cells; acute pancreatitis; nausea & vomiting. Abdominal tenderness (peritonitis) & guaiac +ve colitis w/ concurrent neutropenia & thrombocytopenia in conventional-dose schedules. Severe, fatal CNS, GI & pulmonary toxicity in experimental-dose schedules. Severe fatal pulmonary toxicity, adult resp distress syndrome & pulmonary oedema in high-dose schedules. Cardiomyopathy w/ subsequent death following experimental high-dose therapy; complete alopecia in experimental high-dose therapy. Perform periodic monitoring of bone marrow, liver & kidney functions; daily leukocyte & platelet counts. Monitor blood uric acid levels. High-dose use. Avoid use w/ live or live-attenuated vaccines. Preexisting hepatic dysfunction, renal or hepatic impairment. Women of childbearing potential should use effective contraception. Not recommended during pregnancy. Not to be used during lactation.

Sepsis, pneumonia, infection; bone marrow failure, thrombocytopenia, anaemia, megaloblastic anaemia, leukopenia, decreased reticulocyte count; stomatitis, mouth ulceration, anal ulcer & inflammation, diarrhoea, vomiting, nausea, abdominal pain; abnormal hepatic function; alopecia, rash; cytarabine syndrome; cerebral & cerebellar disorder, somnolence; haemorrhagic conjunctivitis, corneal disorder; acute resp distress syndrome, pulmonary oedema. Anorexia; bleeding, thrombophlebitis; skin ulceration; necrotising colitis; skin rash leading to desquamation.

Severe neurological reactions w/ intrathecal MTX. Reduced effectiveness of MTX. Decreased steady-state plasma digoxin conc. Antagonism for K pneumoniae strains susceptibility w/ gentamicin. Inhibition of fluorocytosine efficacy therapy. Incompatibility w/ heparin, insulin, fluorouracil, penicillins (eg, oxacillin, penicillin G Na), methylprednisolone Na succinate.

Cytotoxic Chemotherapy

L01BC01 - cytarabine ; Belongs to the class of antimetabolites, pyrimidine analogues. Used in the treatment of cancer.

B