Cytarabine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV/SC Induction and maintenance of remission in acute leukaemias As monotherapy: 200 mg/m2/day by continuous IV infusion for 5 days, at intervals of approx 2 wk. In combination therapy: 100 mg/m2 bid by rapid IV inj or 100 mg/m2/day by continuous IV infusion both for 7 days. Maintenance: 1-1.5 mg/kg once or twice wkly via IV or SC. Intrathecal Leukaemic meningitis 5-75 mg/m2 or 30-100 mg once every 2-7 days to once daily for 4 or 5 days. For lymphomatous meningitis: 50 mg every 2 wk for 5 doses, then every 4 wk for 5 doses.
Dosage Details
Intrathecal
Leukaemic meningitis
Adult: 5-75 mg/m2 or 30-100 mg once every 2-7 days to once daily for 4 or 5 days. For lymphomatous meningitis: 50 mg every 2 wk for 5 doses, then every 4 wk for 5 doses.

Parenteral
Induction and maintenance of remission in acute leukaemias
Adult: As monotherapy: 200 mg/m2 daily by continuous IV infusion for 5 days, at intervals of approx 2 wk. In combination therapy: 100 mg/m2 bid by rapid IV inj or 100 mg/m2 daily by continuous IV infusion both for 7 days. Maintenance: 1-1.5 mg/kg once or twice wkly via IV or SC.
Reconstitution
IV: Reconstitute w/ bacteriostatic water for inj (standard-dose), further dilute in 250-1,000 mL NaCl 0.9% or dextrose 5% in water for infusion. Intrathecal: Reconstitute w/ preservative free NaCl 0.9%, further dilute w/ Elliot’s B soln, NaCl 0.9% or lactated Ringer’s inj to preferred final vol (up to 12 mL).
Incompatibility
Y-site: Incompatible w/ caspofungin, allopurinol, ganciclovir, gallium nitrate.
Contraindications
Patient w/ active meningeal infection.
Special Precautions
Patient w/ previous drug-induced bone marrow suppression. Renal or hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, vomiting, fever, rash, diarrhoea, anorexia, oral and anal inflammation or ulceration, hepatic dysfunction, headache, weakness, confusion, thrombocytopenia, fatigue.
Potentially Fatal: Chemical arachnoiditis, bone marrow suppression. Viral, fungal, bacterial, saprophytic or parasitic infections. Pulmonary toxicity, sudden resp distress syndrome and pulmonary oedema (high-doses).
IT/IV/Parenteral/SC: D
MonitoringParameters
Monitor LFTs, CBC w/ differential and platelet count, BUN, serum uric acid, serum creatinine. Monitor for signs of an immediate reaction, chemical arachnoiditis, neurotoxicity.
Overdosage
Symptoms: Irreversible CNS toxicity and death. Severe arachnoiditis including encephalopathy. Management: Therapy cessation followed by treatment of ensuing bone marrow depression including whole blood or platelet transfusion and antibiotics. Maintain vital functions.
Drug Interactions
May reduce efficacy of 5-fluorocytosine, digoxin, gentamicin. May increase risk of neurotoxicity w/ other cytotoxic agents (intrathecal).
Action
Description: Cytarabine inhibits deoxyribonucleic acid (DNA) synthesis specifically at the S-phase of the cell cycle. It also has an antiviral and immunosuppressant activity.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 20-60 min (IM/SC).
Distribution: Crosses the placenta and blood-brain barrier w/ CSF levels of 40-50% of plasma level. Volume of distribution: 3±11.9 L/kg. Plasma protein binding: 13%.
Metabolism: Converted by phosphorylation to an active form followed by deamination in the liver and kidneys to inactive uracil arabinoside (ARA-U).
Excretion: Via urine (mostly as inactive metabolite; approx 10% as unchanged drug). Elimination half-life: Initial: Approx 10 min (IV); terminal: 1-3 hr (IV), 100-263 hr (intrathecal).
Chemical Structure

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Storage
IV/SC: Store between 15-25°C. Intrathecal: Store between 2-8°C. Avoid freezing.
ATC Classification
L01BC01 - cytarabine ; Belongs to the class of antimetabolites, pyrimidine analogues. Used in the treatment of cancer.
Disclaimer: This information is independently developed by MIMS based on Cytarabine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Cytarine
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