Cytarabine (Cytosar, Cytosar-U, Ara-C)

Warning: Treatment with Cytarabine can cause serious blood disorders and treatment must be monitored closely by a physician.  The underlying condition is a low count of white blood cells and platelets characterized as anemia.  This is caused by the effect of the medication on bone marrow suppression.  Liver degradation can also be a problem.

Cytarabine should be used with caution in patients with pre-existing drug-induced bone marrow suppression. During the entire treatment, Patients must be under close medical supervision. Leukocyte and platelet counts must be performed daily during induction therapy. The medication should be given in a facility that prepares for management of complications immediately after the intravenous. It is reported a case of a life-threatening type of allergic reaction that resulted in acute cardiopulmonary arrest and required resuscitation has been reported.

Both during treatment and after, patients must be on the lookout for symptoms of these problems, including yellowing of either the yes or the skin, any signs of infection or colds, and nausea.

Indications:  Cytarabine is a medication used in cancer chemotherapy treatment.  Also known by the brand names Cytosar-U and Tarabine PFS, this medication can be used stand-alone or as part of a group of drugs prescribed to slow or stop the growth of cancerous cells.

Cytarabine in used alone or in combination with other chemotherapy agents to treat:

  • Certain types of leukemia
  • Non-Hodgkin’s lymphoma

Dosage:  The most common method of administration of Cytarabine to the patient is through injection into a vein.  However, physicians may vary the method of administration for particular medical conditions.  There is no fixed dosage for this drug; the physician will tailor the dosage to each patient depending on body mass and the specific medical condition.  In addition, he will monitor the response of each patient to the drug during treatment, and adjust the dosage accordingly if necessary.

Unlike many other chemotherapy drugs which require administration by a licensed physician, this medication can be taken by the patient himself in the comfort of his own home.  Before doing so however, the patient must be completely familiar with the protocol of the drug and usage instructions he receives from his health care professional.  Before administering the drug, he must examine the liquid for any signs of problems, including discoloration of the fluid and the presence of particles, and discard the dose if either of these is present.  Indeed, he must learn how to dispose of the drug properly, and how to store it correctly as well.  Unless your physician tells you otherwise, drink plenty of fluids during the course of the treatment.  The increased fluids allow the kidneys to do their job and efficiently flush the drug from your body.  This in turn can help lessen the accompanying side effects of the treatment.

Overdose:  Cases of deterioration of the function of the heart muscle (myocardium) with subsequent death have been reported following experimental high-dose therapy with cytarabine in combination with cyclophosphamide when used for bone marrow transplant preparation. It is also reported a syndrome of sudden respiratory distress, rapidly resulted in accumulation of fluid in the lungs has been reported following experimental high-dose therapy with cytarabine used for the treatment of relapsed leukemia.

Mechanism of action (MOA):  Cytarabine works by selectively inhibiting DNA synthesis. Once their DNAs are damaged, cancer cells (also healthy normal) which require DNA to reproduce become unable to multiply. Unfortunately some rapidly dividing healthy cells are damaged by Cytarabine.

Contraindications: It is important to inform your physician if you have any allergic reactions to Cytarabine.  Patients will be sensitive to the oral polio vaccine, and should not be immunized during the treatment, or associate closely with anyone who has during the treatment period.

Cytarabine can affect the liver and/or kidney functions. A strict hematologic, hepatic (liver), renal (kidney) monitoring is necessary during the therapy,  particularly during the induction phase. It is also important that your doctor regularly do tests to check your bone marrow status.

Interactions: It is important give your doctor and pharmacist a list of any prescription or over the counter medications you are taking, including any herbal remedy.  During the course of the treatment, don’t alter the frequency or dosages of any of these medications.  The potential side effects of this medication are non-trivial, but are not enumerated in this document.  The patient should specifically monitor interactions with digoxin, flucytosine, or gentamicin.

Talk to your health care provider before taking the following medicines:

  • vaccins
  • Ganciclovir  , an antiviral drug
  • Amphotericin B, a polyene antifungal drug
  • Azathioprine  , an immune system inhibitor
  • Digoxin, a medication used in the treatment of several heart conditions
  • Plicamycin  , a chemotherapy used to stop the growth of cancer cells
  • Amiodarone  , a medication used to treat irregular heart beat
  • Barbiturates,  depressant drug that causes relaxation and sleepiness
  • Cimetidine  , a drug used to inhibit the production of acid in the stomach
  • Colchicines  , a medication used to treat pain associated with gouty arthritis
  • Cyclophosphamide  (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers
  • Cyclophosphamide (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers.

Side effects:  Cytarabine also attack healthy cells that multiply quickly, which can cause various adverse effects:

  • decreased appetite
  • weight loss
  • nausea and vomiting
  • Cramp or tingling in the hands or feet

Cytarabine can cause serious side effects which require medical attention; contact your doctor immediately if you experience any of these symptoms:

  • painful urination
  • bloody urine
  • muscle weakness
  • persistent cough and sore throat
  • abdominal pain
  • blurred vision
  • severe depression
  • black, tarry stools
  • unusual bruising or bleeding
  • yellowing of the skin or eyes
  • swelling and pain at the injection site
  • Fever, which can be a sign of infection

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