|Composition : || Each vai l contains: |
Cytarabine ----------------100mg ,500mg ,1000mg.
Water for injection ------qs.
|Indications : || Acute non-lymphocytic leukemia of adult and paediatric patients, acute lymphocytic leukaemia chronic myelogenous leukaemia (Blast - phase), meningeal leukaemia (intra - thecal administrations) |
|Contraindications : || In patients with history of hypersensitivity to the drug, pregnancy, location. |
| Pharmacological action: || It is an antineoplastic and immuno modulating agent. It is an amino pyrimidine. It acts mainly in the s-phase of cell cycle when cell is undergoing DNA synthesis. It acts by inhibition of DNA polymerase |
|Adverse Effects : ||: Bone marow depression which is dose and schedule dependent, nausea, vomiting, diarrhoea, abdominal pain, oral ulceration, hepatic dysfunction infections, paraplegia and necrotising ieukoencephalopathy occurs after intrathecal administration. |
Cytarabine syndrome usually occurs 6-12 hours following drug administration. Its characterized by fever, myalgia, bone pain, maculopapular rash, conjunctivitis and malaise. It is treated with steroids.
|Dosage : ||In induction therepy of: Acute non lymphocytic Leukaemia - 100 mg. / m² / day continuous i.v infusion (days 1-7) or 100 mg./m² i.v every 12 hrs. In meningococcal Leukaemia: |
Intrathecal - 5 mg/m²- 75 mg/m² of BSA most frequently used dose in 30 mg/m² every 4 days until CSF findings are negative cytarabine liposome:
Intrathecal - 5 mg/m²- 75 mg/m² of BSA most frequently used dose in 30 mg/m² every 4 days until CSF findings are negative cytarabine liposome
| Drug interaction: || The physician should be alert for possible combined drug actions, desirable or undesirable, involving cyclophosphamide even though cyclophosphamide has been used successfully concurrently with other drugs, including other cytotoxic drugs.Cyclophosphamide treatment, which causes a marked and persistent inhibition of cholinesterase activity, potentiates the effect of succinylcholine chloride. |
Since cyclophosphamide has been reported to be more toxic in adrenalectomized dogs, adjustment of the doses of both replacement steroids and cyclophosphamide may be necessary for the adrenalectomized patient..
| Precautions: || Special attention to the possible development of toxicity should be exercised in patients being treated with cyclophosphamide if any of the following conditions are present.|
Tumor cell infiltration of bone marrow
Previous X-ray therapy
Previous therapy with other cytotoxic agents
During treatment, the patient's hematologic profile (particularly neutrophils and platelets) should be monitored regularly to determine the degree of hematopoieticsuppression. Urine should also be examined regularly for red cells which may precede hemorrhagic cystitis.