Cytarabine (Cytosine arabinoside) 100mg/5ml
vial: Injection for i.v infusion.
Mode of action: Cytarabine is a cytotoxic antimetabolite. It's exact mechanism of action is unknown. In the body, cytarabine is converted to cytarabine triphosphate which inhibits the synthesis of DNA (by interfering with pyrimidine synthesis- a component of DNA) by inhibiting DNA polymerase.
Ind: Predominant use in the induction of remission of acute myelocytic leukemia. Used singly or in combination therapy with other chemotherapeutic agents for the remission
induction in lymphocytic leukemia, chronic myeloid leukemia, erythroleukemia and in the treatment and maintenance therapy of meningeal leukemia .and other meningeal neoplasma.
C/I: Cytarabine is contraindicated in patients with a known hypersensitivity to the drug.
AIR: The major adverse effect of cytarabine is hematologic toxicity. Myelosuppressinon is manifested by megaloblastosis, leucopenia, anemia, reticulopenia and thrombocytopenia. The severity of these adverse effects depend on the dose and the schedule of administration. Nausea and vomiting usually occur more frequently following rapid i.v administration as opposed to continuous infusion of the drug. I Other adverse effects of the GI tract includeanorexia, diarrhoea, oral and anal inflmmation,
abdominal pain, oesophagitis, sore throat, oesophageal ulceration and GI hemorrhage. Due to its immunosuppressive effect viral, bacterial, fungal & parasitic infection may occur. Hepatic dysfunction characterised by jaundice, elevation in serum bilirubin, transaminase and alkaline phosphatases have also ocurred. Other less major adverse effects include- fever, rash, conjuctivitis, alopecia, chest pain, dizziness, myalgia, bone pain, hyperuricemia, cardiac and respiratory distress etc.
Use in lactation: Women should be advised not to breast-feed while being treated with cytarabine.
Dosage & admin: Single drug therapy in the induction of remission in adults with acute .
myelocytic leukemia: Cytarabine 200mg!m2 daily by continuous i. v infusion over 24 hrs for 5 days (120 hrs)- total dose 1000mg!m2. The course is repeated every 2 weeks.
Modifications based on hematologic response should be made. Clinical experience to date indicates that success with cytarabine therapy depends more on adeptness in modifying day to day dosage to obtain maximum leukemia cell kill with tolerable toxicity. Therefore dosage of cytarabine must be based on clinical & hematologic response & tolerance of the patient.
Cytarabine can be administered intravenously either as a bolus push or as a continuous infusion. It may also be administered subcutaneously or intrathecally.
Cytarabine combination therapy: Plesae see package insert.
Drug inter: To be cautious when using other myelosuppressive drugs concurrently as the incidence and severity of hemotologic toxicity
may be exacerbated. Patient may develop acute pancreatitis during cytarabine treatment if he had prior treatment with L-asparaginase.
100mg (5ml) vial: 116.42 MRP
(Price could not be revised).