Indications
Cytarabine is a cancer medicine used mainly for blood cancers:
- Acute myeloid leukaemia (AML), to bring it into remission and to keep it there.
- Acute lymphoblastic leukaemia (ALL) and some non-Hodgkin lymphomas, as part of combination treatment.
- Leukaemia or lymphoma that has spread to the lining of the brain and spinal cord (given into the spinal fluid).
How It Works
Cytarabine is an antimetabolite. Inside cells it is changed into a form that blocks the copying of DNA, so fast-dividing cells, such as leukaemia cells, cannot multiply and die.
Dosage and Administration
Cytarabine is an injection given in hospital by a doctor or nurse, into a vein (by drip or injection), under the skin, or into the spinal fluid. The dose and schedule depend on the type of cancer, body size, blood counts and other medicines used, and are as prescribed by the cancer specialist. It is never used at home without specialist instructions.
Interactions
- Other chemotherapy medicines and radiotherapy can add to its effect on the bone marrow.
- It may reduce the absorption of Digoxin tablets and reduce the effect of Flucytosine.
- Live vaccines must be avoided during treatment and for some time afterwards.
- Tell the team about every medicine, including herbal products.
Contraindications
- Allergy to cytarabine.
- Severe bone marrow suppression not caused by the cancer itself, unless the specialist decides the benefit is greater than the risk.
Side Effects
Common:
- Low blood counts, raising the risk of infection, bleeding and anaemia.
- Nausea, vomiting, diarrhoea, loss of appetite and mouth ulcers.
- Hair thinning, rash, and changes in liver tests.
- Cytarabine syndrome: fever, muscle or bone pain, rash, red eyes and feeling unwell, usually 6 to 12 hours after a dose.
- With high doses: sore, red, watery eyes (eye drops are usually given) and effects on the brain such as unsteadiness, slurred speech or confusion.
Get urgent medical help for a temperature of 38°C or more, shivering, unusual bleeding or bruising, black stools or blood in vomit, breathlessness, severe stomach pain, yellow eyes or skin, confusion, unsteady walking or slurred speech.
Pregnancy and Lactation
Cytarabine can harm an unborn baby. Both women and men should use reliable contraception during treatment and for the period the doctor advises afterwards. Do not breastfeed during treatment.
Precautions and Warnings
- Regular blood tests and liver and kidney checks are needed.
- Avoid people with infections and wash hands often while blood counts are low.
- Drink plenty of fluids unless told otherwise; extra medicines may be given to protect the kidneys.
- Tell the team about liver disease, kidney disease or earlier radiotherapy.
Overdose
Because it is given in hospital, overdose is rare. Too much can cause severe bone marrow suppression and brain effects, and is managed by the hospital team with close monitoring and support.
Therapeutic Class
Antineoplastic (anticancer), pyrimidine antimetabolite.
Storage
Stored by the hospital or pharmacy as directed on the pack, usually below 25°C and away from light. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.