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How does this medication work? What will it do for me?
Cytarabine belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as antimetabolites. Cytarabine fights cancer by preventing the growth of cancer cells, which eventually results in their destruction. Cytarabine is used alone or in combination with one or more other medications to treat leukemia and lymphoma.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each mL of sterile, non-pyrogenic, white-to-off-white suspension of cytarabine contains 10 mg of cytarabine. Nonmedicinal ingredients: sodium chloride 0.9% in water for injection, cholesterol, triolein, dioleoylphosphatidylcholine (DOPC), dipalmitoylphosphateidylglycerol (DPPG), glucose, l-lysine, and residual chloroform.
How should I use this medication?
Cytarabine is available as an intrathecal (into the space between the layers of tissue covering the brain and spinal cord) injection, subcutaneous (under the skin) injection, and an intravenous (into a vein) injection. The recommended dose of cytarabine and how the cytarabine is used varies according to the specific condition being treated, the response to therapy, the other medications used, the stage of the cancer, and body size.
When given into a vein, it is usually injected through a site on your skin specially prepared for this purpose. Very careful handling of this medication is required. It is always administered in a hospital or similar setting with access to sterile equipment for preparation.
The schedule of dosing depends on which other medications are being used (if any). Usually treatments are given on a daily basis for a period of time followed by a rest period and then the treatment schedule is repeated.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive cytarabine, contact your doctor as soon as possible to reschedule your appointment.
As well as interfering with the genetic material of cancer cells, cytarabine can interfere with some of your normal cells. This may cause a number of side effects such as mouth sores. Keep track of any side effects and report them to your doctor.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you are allergic to cytarabine or any ingredients of the medication.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- freckling of skin
- loss of appetite
- personality changes
- temporary hair loss (more common with higher doses)
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- difficulty swallowing or sore throat
- fluid retention with swelling of the stomach, legs, ankles or feet
- flu-like symptoms (e.g., sore throat, cough, fever, chills)
- muscle or bone pain
- numbness or tingling in fingers, toes, or face
- pain, redness, or swelling at the site of injection
- rash or blisters on the palms of the hands and soles of the feet
- sudden shortness of breath
- red, painful, or irritated eyes, blurred vision (more common at higher doses – your doctor may prescribe eye drops to prevent or treat this condition)
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, painful or difficult urination)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- signs of pneumonia (e.g., cough with or without mucus, fever, chills, shortness of breath)
- sores in mouth and on lips
Contact your doctor immediately if any of the following side effects occur:
- confusion, memory loss, speech difficulties or difficulty with motor control (more common at higher doses)
- dizziness or unusual tiredness while you are receiving your treatment
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)
- signs of a blood infection (e.g., dizziness, confusion, diarrhea, nausea, vomiting, slurred speech, severe muscle pain)
- signs of heart problems (e.g., shortness of breath, swelling of the legs, irregular heartbeat, chest pain)
- signs of tumor lysis syndrome (nausea, vomiting, decreased urination, irregular heartbeat, confusion, seizures, delirium)
A flu-like syndrome including symptoms such as fever, muscle, or joint pain; rash (especially on palms, soles, neck, and chest); a feeling of being unwell; chest pain; and redness or irritation of eyes may occur. This is most likely to occur 6 to 12 hours after your treatment. It is important to get medical help immediately if any of these symptoms occur shortly after your treatment.
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Anemia: Cytarabine may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor if there are any signs that your blood is not clotting as quickly as usual. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won’t stop bleeding.
Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people who have contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness.
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Lung inflammation: Lung inflammation (interstitial lung disease), causing difficulty breathing has occurred rarely in some people taking this medication. This complication can be serious and sometimes fatal. If you experience new or worsening shortness of breath or cough (with or without fever) at any time while you are taking cytarabine, contact your doctor immediately.
Pancreatitis: This medication can cause the pancreas to become inflamed. Report signs of pancreatitis such as abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, or swollen abdomen to your doctor immediately.
Tumour Lysis Syndrome: Cytarabine, like many other cancer medications, causes many cancer cells to be suddenly killed when treatment is first started. This can overwhelm the body with waste products from the cells. As a result, the body may not be able to keep up with getting rid of all the waste. When this happens, you may experience nausea, shortness of breath, cloudy urine, or joint pain. This is called tumour lysis syndrome. Your doctor may prescribe some medications to help your body get rid of the waste products. Make sure you understand how to use these medications and report any of these signs or symptoms to your doctor immediately.
Pregnancy: There is a possibility of birth defect if either the father or the mother is using cytarabine at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using this medication. Tell your doctor immediately if you become pregnant while using this medication. It should only be used during pregnancy if potential benefits clearly outweigh the risks.
Breast-feeding: It is not known whether cytarabine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Because of the risks associated with this medication, a decision should be made to stop breast-feeding or stop taking the medication, taking into account the importance of the medication to the mother. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children less than 1 year of age.
What other drugs could interact with this medication?
There may be an interaction between cytarabine and any of the following:
- amphotericin B
- corticosteroids (e.g., budesonide, dexamethasone, hydrocortisone, fluticasone, prednisone)
- other medications to treat cancer (e.g., carboplatin, cyclophosphamide, doxorubicin, ifosfamide, vincristine)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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