WARNING

Cytarabine is a chemotherapy medication primarily used to treat certain types of leukemia, including acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL). While it can be effective in treating cancer, it also comes with several potential risks and side effects:

• Bone Marrow Suppression: Cytarabine can significantly lower the production of blood cells in the bone marrow, leading to anemia, increased risk of infection, and bleeding problems.
• Gastrointestinal Effects: Common side effects include nausea, vomiting, diarrhea, and mouth sores.
• Neurological Effects: High doses can cause neurotoxicity, leading to symptoms such as confusion, dizziness, headache, seizures, and, in severe cases, cerebellar syndrome (loss of coordination and balance).
• Liver and Kidney Damage: Cytarabine can cause liver and kidney toxicity, requiring regular monitoring of liver and kidney function during treatment.
• Respiratory Problems: It may cause lung-related side effects like difficulty breathing or pulmonary edema.
• Cytarabine Syndrome: A flu-like syndrome characterized by fever, muscle and bone pain, rash, and conjunctivitis, typically occurring within hours of administration.
• Allergic Reactions: Rarely, it can cause severe allergic reactions, including anaphylaxis.
• Heart Problems: Rare but serious heart problems, including chest pain and arrhythmias, may occur, particularly in older patients or those with pre-existing heart conditions.

Patients taking cytarabine should be closely monitored by their healthcare provider to manage and mitigate these risks effectively.

Why is this medication prescribed?

Cytarabine is primarily prescribed as a chemotherapy drug to treat certain types of blood cancers. Cytarabine is a key medication in the treatment of AML, often used in combination with other chemotherapy drugs. It is also used to treat ALL, another type of blood cancer. In some cases, cytarabine may be used to manage certain phases of CML. It is sometimes used in treating lymphomas that affect the central nervous system (CNS). It works by interfering with the DNA synthesis of cancer cells, preventing them from multiplying and leading to their eventual death.

How should this medicine be used?

Cytarabine is used primarily in the treatment of various types of cancer, including leukemia and lymphoma. Here’s how it is generally used:

• Intravenous (IV) Injection: Cytarabine is most commonly administered directly into a vein through an IV line. This is usually done in a hospital or clinic setting.
• Subcutaneous Injection: In some cases, Cytarabine may be given as an injection under the skin.
• Dosage: The dosage of Cytarabine varies depending on the specific type of cancer being treated, the patient’s overall health, and other factors. Your healthcare provider will determine the appropriate dose.
• Schedule: Cytarabine is often given in cycles. For example, you might receive the drug daily for a period (e.g., 7 days) followed by a rest period (e.g., 21 days) before starting the next cycle. The exact schedule will be tailored to your treatment plan.
• Healthcare Setting: Cytarabine is usually prepared by a healthcare professional in a sterile environment to prevent contamination.
• Home Use: If Cytarabine is prescribed for home use (less common), follow the instructions provided by your healthcare provider or pharmacist carefully.
• Blood Tests: Regular blood tests are required to monitor your response to the medication and check for any side effects. These tests help adjust the dosage and manage any adverse effects.
• Precautions: Cytarabine is a potent medication, and proper handling procedures should be followed to avoid exposure. Healthcare providers will take necessary precautions to minimize exposure.

Always follow your healthcare provider’s instructions and ask any questions you might have about the administration of Cytarabine. If you experience any problems or have concerns during treatment, contact your healthcare provider for guidance.

Other uses for this medicine

• Myelodysplastic Syndromes (MDS): In some cases, Cytarabine is used to manage myelodysplastic syndromes, a group of disorders caused by poorly formed or dysfunctional blood cells.
• Lymphoma: It may be used as part of a combination chemotherapy regimen for certain types of non-Hodgkin lymphoma, particularly those involving the CNS.
• Ocular Lymphoma: Cytarabine can sometimes be administered intrathecally or intravitreally (directly into the eye) for the treatment of lymphoma involving the eye.

What special precautions should I follow?

If you are prescribed Cytarabine, there are several important precautions you should follow to ensure your safety:

• Inform Your Healthcare Provider About Medical History: Notify your doctor if you have any pre-existing conditions, especially liver or kidney disease, heart problems, infections, or neurological issues.
• Discuss Allergies: Inform your healthcare provider if you are allergic to Cytarabine or any other medications, including any excipients in the formulation.
• Pregnancy and Breastfeeding: Cytarabine can cause harm to a developing fetus, so it should not be used during pregnancy unless absolutely necessary. Effective contraception should be used during treatment and for some time after completion. Breastfeeding is not recommended while using Cytarabine, as it can pass into breast milk and may harm the nursing baby.
• Avoid Live Vaccinations: Do not receive any live vaccines (like measles, mumps, rubella, or yellow fever) during Cytarabine treatment, as the medication can weaken your immune system, increasing the risk of contracting infections from the vaccine.
• Prevent Infections: Due to the risk of bone marrow suppression and reduced white blood cell count, practice good hygiene, avoid contact with sick people, and report any signs of infection (such as fever, sore throat, or cough) immediately to your healthcare provider.
• Monitor for Side Effects: Be aware of potential side effects like nausea, vomiting, diarrhea, mouth sores, neurotoxicity (such as confusion, dizziness, or seizures), respiratory issues, and signs of liver or kidney damage. Report any severe or unusual symptoms to your doctor immediately.
• Stay Hydrated: Ensure adequate fluid intake, as Cytarabine can affect kidney function, especially at high doses.
• Blood Tests and Monitoring: Regular blood tests are necessary to monitor your blood counts (white cells, red cells, and platelets), liver function, and kidney function. Follow your healthcare provider’s instructions regarding test schedules.
• Driving and Operating Machinery: Cytarabine can cause dizziness, confusion, and other neurological effects. Avoid driving or operating heavy machinery if you experience these symptoms.
• Sun Protection: Cytarabine may make your skin more sensitive to sunlight. Wear protective clothing and use sunscreen if you are exposed to the sun.

By following these precautions, you can help manage the risks associated with Cytarabine treatment. Always consult your healthcare provider for specific advice tailored to your condition.

What special dietary instructions should I follow?

• Dietary Adjustments: There are no specific dietary restrictions associated with Cytarabine, but maintaining a balanced diet can help manage side effects like nausea and loss of appetite.
• Hydration: Ensure adequate fluid intake to support kidney function and reduce the risk of dehydration.

What should I do if I forget a dose?

• Missed Dose: If you miss a dose of Cytarabine, contact your healthcare provider for instructions. Do not double up on doses to make up for a missed one.
• Schedule: Follow the dosing schedule provided by your healthcare provider or pharmacist. Keep a record of your doses to help avoid missed doses.

What side effects can this medication cause?

Cytarabine can cause a range of side effects. Here are some of the common and serious side effects associated with this medication:

Common Side Effects:

• Nausea and Vomiting: These are common, especially shortly after administration.
• Diarrhea: Can be severe in some cases.
• Mouth Sores: Painful sores can develop in the mouth and throat.
• Loss of Appetite: Decreased appetite may occur.
• Fatigue: General tiredness and weakness.
• Hair Loss: Temporary hair loss may occur.

Serious Side Effects:

• Bone Marrow Suppression: Decreased production of blood cells can lead to anemia, bleeding problems, and increased risk of infections. Symptoms might include unusual bruising, bleeding, frequent infections, or pale skin.
• Severe Infections: Due to the suppression of the immune system, you might be more susceptible to infections.
• Pulmonary Toxicity: Symptoms like shortness of breath, cough, or chest pain might occur.
• Hepatotoxicity: Liver damage, indicated by symptoms such as jaundice (yellowing of the skin or eyes), dark urine, or abdominal pain.
• Neurological Effects: In rare cases, Cytarabine can cause neurological symptoms such as confusion, difficulty speaking, or seizures.
• Gastrointestinal Issues: Severe diarrhea or abdominal pain.
• Eye Problems: Symptoms like redness, pain, or vision changes.
• Heart Issues: Rarely, Cytarabine can cause heart-related problems.

Seek immediate medical attention if you experience symptoms of a serious allergic reaction such as rash, itching/swelling, severe dizziness, or trouble breathing. It’s important to discuss any side effects with your healthcare provider, as they can provide guidance on managing them and may adjust your treatment plan if needed.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cytarabine:

• Storage: Cytarabine is usually stored by a healthcare provider. If you are storing it at home, follow the instructions given by your healthcare professional or the medication label. Store it at room temperature away from light, moisture, and heat. Do not freeze Cytarabine.
• Disposal: Do not dispose of Cytarabine in the household trash or flush it down the toilet. Follow your local guidelines for safe disposal of medical waste or ask your pharmacist or healthcare provider about proper disposal methods.

In case of emergency/overdose

• Symptoms of Overdose: Symptoms of a Cytarabine overdose may include nausea, vomiting, diarrhea, mouth sores, fever, chills, unusual bleeding or bruising, and extreme fatigue. In severe cases, it may cause respiratory distress, neurological problems, and organ failure.
• What to Do: In case of an overdose, call emergency services immediately or contact a poison control center. If the person collapses, has a seizure, has trouble breathing, or can’t be awakened, seek emergency medical assistance right away.

What other information should I know?

• Regular Monitoring: You will likely need frequent medical tests (like blood counts) to monitor your body’s response to Cytarabine. Keep all appointments with your doctor and the laboratory.
• Avoid Infections and Bleeding: Cytarabine can lower your immune response and platelet count, so avoid close contact with people who have infections. Be careful to avoid injuries that may cause bleeding.
• Hydration: Ensure adequate hydration during treatment, as Cytarabine can cause kidney damage in some cases.
• Notify Your Doctor: Inform your healthcare provider of any other medications you are taking, including prescription, over-the-counter drugs, supplements, or herbal products.
• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Cytarabine can harm an unborn baby and is not recommended during pregnancy unless necessary.

Always follow your healthcare provider’s advice and read the medication guide or patient information leaflet that comes with the drug for detailed instructions and warnings.