Indications
Cytosar Injection is used for:
Acute myeloid leukaemia, acute lymphocytic leukaemia (ALL), lymphomas, Leukaemic meningitis
Adult Dose
Acute Nonlymphocytic Leukemia
IV administration for remission induction
100-200 mg/sq.meter/day for 5-10 days; begin second course in 2-4 weeks after initial therapy if necessary OR
100 mg/sq.meter for 7 days OR
100 mg/sq.meter/dose q12hr for 7 days
Intrathecal (IT) administration for remission induction
5-75 mg/sq.meter q2-7Days until CNS findings normalize
IV administration for remission maintenance
70-200 mg/sq.meter/day for 2-5 days at monthly intervals
IM administration for remission maintenance
1-1.5 mg/kg single dose for maintenance at 1- 4 week intervals
Meningeal Leukemia
IT administration
30 mg/sq.meter intrathecal (IT) q4Days until CSF findings normal plus one additional dose
Refractory Leukemia
IV administration
3 g/sq.meter IV (infusion over 1-3 hours) q12hr x 4-12 doses
Repeat q2-3Weeks
Child Dose
Renal Dose
Administration
IV Administration
Rapid IV, infusion over 1-3 hr, or SC intrathecal
Has been administered by IM & continuous SC infusion
IT: Patient should lie flat for 1 hour after lumbar puncture
Liposomal: To reduce incidence of arachnoiditis, administer dexamethasone concurrently
IV Preparation
Reconstitute vials in BWI containing benzyl alcohol 0.945% as follows (CAUTION: Do not use benzyl alcohol for intrathecal inj)
100 mg vial: add 5 mL diluent to 20 mg/mL
500 mg vial: add 10 mL diluent to 50 mg/mL
1 g vial: add 10 mL diluent to 100 mg/mL
2 g vial: add 20 mL diluent to 100 mg/mL
Contra Indications
Hypersensitivity; pregnancy and lactation.
Precautions
Hepatic and renal dysfunction, severe infections, preexisting drug-induced bone marrow suppression. Monitor WBC, platelet counts and blood uric acid frequently. Assess renal and hepatic function periodically.
Lactation: not known if excreted in breast milk, avoid
Pregnancy-Lactation
Interactions
May reduce efficacy of gentamicin, digoxin and flucytosine.
Potentially Fatal: Potentiates bone marrow depression with radiotherapy and other myelotoxic drugs.
Adverse Effects
Side effects of Cytarabine :
1-10%
Anorexia,Nausea,Vomiting,Diarrhea,Oral/anal inflammation,Thrombophlebitis,Bleeding,Myelosuppression,Rash,Fever,Hepatic dysfunction
Frequency Not Defined
Headache,Neuropathy,Chest pain,Pericarditis,Pneumonia,Anemia,Bleeding,Leukopenia,Thrombocytopenia,Kidney disease,Infectious disease,Sepsis,"Cytarabine syndrome": fever, myalgia, bone pain, rash, conjunctivitis, malaise,Skin ulcers,Cellulitis,Urinary retention,Neuritis,Jaundice,Anaphylaxis
Potentially Fatal: Convulsions. Cerebellar dysfunction, respiratory distress syndrome, GI perforation, bone marrow suppression.
Mechanism of Action
Cytarabine acts by interfering with DNA synthesis specifically at the S-phase of the cell cycle. It is a potent myelosuppressant and requires careful haematological monitoring during its use. It also has antiviral property.
Note
Cytosar 100mg Injection manufactured by Pfizer Ltd.. Its generic name is Cytarabine. Cytosar is availble in Nepal.
Farmaco Nepal drug index information on Cytosar Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.