CYTARABINE

Antimetabolite anticancer.

Dosage Forms

Injection

100 mg/ml

Uses

  • Induction of remission in acute myeloid leukaemia
  • Acute leukaemias

Dose and Duration

Can be given by IV infusion or injection, or SC injection
Remission induction
  1. Continuous
    1. Rapid injection: starting dose 2 mg/kg/day. Administer for 10 days. Obtain daily blood counts. If no antileukaemic effect or toxicity noted, increase to 4 mg/kg/day and maintain until therapeutic response or toxicity is evident.
    2. 0.5‒1.0 mg/kg/day may be given in an infusion of up to 24 hours duration. After 10 days this initial daily dose may be increased to 2 mg/kg/day subject to toxicity. Continue to toxicity or until remission occurs.
  2. Intermittent treatment:
    1. 3‒5 mg/kg/day are administered IV on each of 5 consecutive days. After a 2‒90 day rest period, a further course is given. Continue until response or toxicity occurs.
Improvement usually occurs between 7‒64 days after the beginning of therapy (mean 28 days).
Patients seem to tolerate higher doses when given by rapid IV injection as compared with slow infusion due to the rapid metabolism of cytarabine.
Maintenance therapy
Remissions induced by cytarabine, or by other drugs, may be maintained by IV or SC injection of 1 mg/kg once or twice weekly.

Contraindications

  • Hypersensitivity to cytarabine

Side Effects

  • Myelosuppression
  • Mucositis (mouth and anal)
  • Nausea, vomiting, diarrhoea, abdominal pain
  • Fever
  • Rash
  • Infections and infestations
  • Liver damage
  • CNS toxicity in high doses

Interactions

  • Live vaccines (risk of developing infection by vaccine)
  • Clozapine (risk of agranulocytosis)

Pregnancy

  • Do not use

Breastfeeding

  • Discontinue breastfeeding

⚠️ Caution

  • Careful haematologic monitoring is required
  • Reduce doses in liver impairment
  • Follow manufacturer’s instructions for reconstitution of medicine before administration
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines