Cytarabine

Uses	Acute nonlymphocytic leukemia, Acute lymphocytic leukemia, Blast phase of chronic myeloid leukemia
Therapy	Anti-Neoplastic
Side Effects	Low Blood Counts, Nausea, Fever, Mouth Ulcers

3 Step Quality
Assurance

Cash on delivery
available

NPPA
Regulated

Molecule Description

Cytarabine is an antimetabolite-class anticancer medicine. It is used with other aticancer medicines to manage remission induction in acute nonlymphocytic leukemia in adults and children. It has also been found useful in treating acute lymphocytic leukemia and the blast phase of chronic myeloid leukemia. It works by mimicking a natural DNA building block (cytidine). Once inside a cell, it is converted into its active form and blocks the enzyme DNA polymerase, which cancer cells need to copy their DNA and divide. Because it targets actively dividing cells, it is most effective against fast-growing leukemic cells. Cytarabine is a powerful bone marrow suppressant that reduces the production of white blood cells, red blood cells, and platelets. This can lead to a higher risk of severe infection, anemia, and bleeding, with blood counts usually decreasing. Treatment is given under close supervision of a cancer specialist, with frequent blood tests to monitor counts and determine if a dose should be delayed, reduced, or stopped temporarily. Cytarabine is given by a doctor or nurse as an injection in a hospital setting. Cytarabine may lead to mouth ulcers, diarrhea, hair loss, and abdominal pain. Some patients may experience Cytarabine syndrome, which can occur a few hours after a dose and includes fever, muscle and bone pain, occasional chest pain, a rash, and eye redness. Warning signs that need urgent medical attention include severe abdominal pain, black or bloody stools, unusual bruising or bleeding, difficulty breathing, and confusion or unsteadiness. Before starting Cytarabine, patients should have their doctor review their complete medical history. This includes any liver or kidney issues, current infections, and pregnancy status, because the medication can be harmful to a developing baby. Effective contraception is necessary during treatment. Patients on this medication should also avoid live vaccines and take precautions to prevent infection and injury, since their blood counts may be lower.

Uses

It is used with other anticancer medicines in the management of:
Remission induction in acute nonlymphocytic leukemia in adults and children.
Acute lymphocytic leukemia
Blast phase of chronic myeloid leukemia

Contraindications

When should one not use Cytarabine

Known hypersensitivity (allergy) to Cytarabine or any component of the injection.

Side effects

Common side effects of this drug are:

Bone marrow suppression: low white blood cells (leukopenia), low platelets (thrombocytopenia), anemia
Nausea, vomiting, diarrhea, abdominal pain
Mouth and anal ulcers or inflammation
Fever
Hair loss (alopecia), skin rash
Skin ulceration
Sepsis, pneumonia, and other infections related to low white blood cell counts
Necrotising colitis
Cytarabine syndrome (fever, muscle/bone pain, rash, eye redness, malaise)
High uric acid levels
Fever, chills, or signs of infection
Unusual bleeding or bruising, blood in urine or stool, or severe headache
Severe abdominal pain, distension, or bloody diarrhea.
Chest pain, sudden shortness of breath, or swelling of the legs.
New confusion, difficulty speaking, unsteady walking, blurred vision, or seizures
Eye pain, redness, or excessive tearing,
Severe allergic reaction

Precautions and Warnings

Pregnancy

No, Cytarabine should be avoided during pregnancy. It can harm a developing baby. Women of childbearing potential and men should use effective contraception during treatment, with the duration after treatment confirmed by their doctor.

Breast Feeding

It is not known whether this medicine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants, breastfeeding is not recommended during Cytarabine treatment.

Driving

Cytarabine does not directly impair alertness, but side effects like nausea, dizziness, tiredness, and weakness can affect safety. High doses may cause drowsiness, confusion, or blurred vision. Avoid driving or operating machinery if symptoms are present and consult your doctor.

Alcohol

It's best to avoid or limit alcohol during Cytarabine treatment.Discuss alcohol use with your doctor, particularly because cytarabine treatment can affect the liver and cause gastrointestinal side effects.

Other General Warnings

Talk to your doctor if

You have signs of bone marrow suppression
You notice swelling, high blood pressure, or reduced urine output.
You have pre-existing kidney or liver disease.
You have a history of heart problems
You develop a new infection or have a known chronic infection.
You notice easy bruising, prolonged bleeding from cuts, or blood in your stool or urine
You have any other significant medical condition, such as diabetes, lung disease, or a prior neurological condition.
Report any fever, chills, or infection signs to your treatment team immediately, as low blood counts from Cytarabine can make infections quickly dangerous.
Have your blood counts checked regularly, as advised by your doctor.
Avoid live vaccines during treatment, and check with your doctor before receiving any vaccination.
Use effective contraception during treatment and for a period after, as advised by your doctor.
Report unusual bruising, bleeding, black stools, or blood in urine.
Contact your doctor promptly if you develop severe mouth ulcers, persistent vomiting, eye redness/pain, chest pain, or new confusion or unsteadiness.
Cytarabine should not be given to premature or low birth weight infants when using a diluent containing benzyl alcohol. The preservative is linked to serious adverse events like the “gasping syndrome" and death in children.
Cytarabine is a hospital-administered medicine, so the pharmacy normally handles storage and disposal.
Cytarabine and related infusion supplies are kept safely out of reach of children within the clinical area.

Mode of Action

How Does It Work?

Cytarabine belongs to the antimetabolite class of anti-cancer medicines. It is converted into an active form that resembles a natural DNA building block and interferes with DNA synthesis and replication. It inhibits DNA polymerase, disrupting the replication of rapidly dividing cells. This ultimately leads to the death of leukaemic cells and can help achieve remission.

Interactions

Interactions with other medicines

Cytarabine suppresses the immune system, and receiving a live vaccine while on this treatment may cause a serious or deadly infection from the vaccine strain.
Intrathecal administration of cytarabine with other intrathecal or systemic anticancer medicines requires careful medical supervision because serious neurological toxicity can occur.
High-dose cytarabine used with other potentially cardiotoxic chemotherapy, including cyclophosphamide, may increase the risk of cardiac toxicity.
Cytarabine may temporarily lower digoxin levels reducing its effectiveness.
Cytarabine may reduce gentamicin effectiveness against certain bacteria (Klebsiella pneumoniae).
Cytarabine may reduce the effectiveness of flucytosine.
Patients should tell their doctor about all prescription medicines, over-the-counter medicines, supplements, and herbal products they are taking before and during Cytarabine treatment.

Interactions with food items

No specific food interactions have been established for Cytarabine. Follow any dietary advice given by your doctor or pharmacist during treatment.

Dosage

Overdose

Because Cytarabine is always administered and monitored in a healthcare setting by trained staff, the chance of overdose is very low. There is no antidote for Cytarabine overdose.Treatment is supportive and depends on the clinical situation.

Missed a Dose

If you miss a planned infusion or need to reschedule, contact your doctor as soon as possible.

Frequently Asked Questions (FAQs)

Contact your doctor immediately if you develop a fever, signs of infection, unusual bleeding or bruising, severe abdominal pain, chest pain or breathlessness, sudden vision changes, confusion, or any rapidly worsening symptoms.

Do not stop or skip treatment without speaking to your doctor first. Your doctor can help manage side effects and decide whether treatment should be continued, delayed, or adjusted.

Cytarabine and intensive chemotherapy may affect fertility, including sperm production. If future fertility is a concern, discuss fertility-preservation options with your doctor before treatment.