ADAP drugs: cytarabine

cytarabine
(Ara-C, cytosine arabinoside, Cytosar-U, Tarabine PFS)

Drug description

Ara-C is used in combination with other chemotherapies to treat leukemias and non-Hodgkin's lymphomas. Until recently, it was often tried as a treatment for Progessive Multifocal Leukoencephalopathy (PML). PML is caused by a virus which affects the brain and central nervous system. Ara-C is able to cross the blood-brain barrier, and is injected into the spine for treatment of meningeal leukemia. A recent study found no benefit from ara-C in the treatment of PML.

Side effects
Nausea and vomiting are the most common side effects. Other side effects can be headache, hepatitis, rash, anemia, leukopenia (lower than normal number of white blood cells), thrombocytopenia (decreased number of blood platelets), and fevers. At high doses, symptoms include corneal toxicity, fluid and swelling in the lungs, and hemorrhagic conjunctivitis.

Dosage
Ara-C should not be given to pregnant or breast feeding women. Additive bone marrow depression occurs with radiation therapy. The IV induction dose for adults is 100-200 mg/m2/day or 3 mg/kg/day as a continuous infusion over 24 hours, or divided doses by rapid injection for 5-10 days. The treatment may be repeated in 2 weeks. The high dose regimen is 2-3 g/m2 over 1-3 hours every 12 hours for 2-6 days.

How long it may take to work
Treatment is continued every 2 weeks until the cancer is in complete remission, or blood cell counts fall below acceptable levels.

Managing side effects
Drink at least 2 quarts of fluid each day. Allopurinol may be given to decrease uric acid levels. Administering an antiemetic and adjusting diet as tolerated may help maintain fluid and electrolyte balance and nutritional status. Your doctor will prescribe the best antiemetic for you. The infusion should be given slowly to help decrease side effects. Report any unusual bleeding. Use a soft toothbrush and electric razor, avoid falls, and do not drink alcoholic beverages or take drugs containing aspirin, because these substances can cause gastric bleeding. Check your mouth for redness and ulceration. If you have mouth sores, use a sponge brush and rinse with warm salt water after eating and drinking. Consult with your doctor and nutritionist if pain interferes with your ability to eat.

This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/ and www.healthanswers.com/Library/library_fset.asp

The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information

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