Cytarabine ARA-C Brand Name– Cytosar-U
What is Cytarabine ARA-C
Cytarabine (cytosine arabinoside, Ara-C) is a pyrimidine antimetabolite agent used in the treatment of hematologic malignancies in combination with other chemotherapy agents.
It is a congener of the nucleoside cytidine and deoxycytidine that contains an altered sugar, arabinose, instead of ribose and deoxyribose, respectively.
The limited cytotoxicity of cytarabine in solid tumors is attributed to the lack of metabolic activation and its selective effects against rapidly dividing cells. Cytarabine is most commonly used as part of induction and consolidation regimens in acute myelogenous leukemia.
It is also used as part of combination chemotherapy regimens for acute lymphocytic leukemia, chronic myelogenous leukemia, and Hodgkin’s and non-Hodgkin’s lymphoma.
Intrathecal cytarabine is effective treatment and prophylaxis of central nervous system leukemia and lymphoma.
Cytarabine was granted FDA approval in 1969.
A liposomal cytarabine product (DepoCyt(TM)) is also available.
Indications
- acute lymphocytic leukemia (ALL)
- acute myelogenous leukemia (AML)
- carcinomatous meningitis
- chronic myelogenous leukemia (CML)
- Hodgkin lymphoma
- non-Hodgkin’s lymphoma (NHL)
For the treatment of acute myelogenous leukemia (AML)
for remission induction therapy in AML, in combination with other approved anticancer drugs
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- alopecia
- anaphylactoid reactions
- anemia
- anorexia
- ataxia
- bleeding
- bone marrow suppression
- bone pain
- bowel necrosis
- cardiac arrest
- cardiomyopathy
- chest pain (unspecified)
- colitis
- coma
- confusion
- conjunctivitis
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysarthria
- dyspnea
- edema
- encephalopathy
- esophageal ulceration
- esophagitis
- fever
- Guillain-Barre syndrome
- headache
- hepatotoxicity
- hyperbilirubinemia
- hyperuricemia
- impaired cognition
- infection
- injection site reaction
- jaundice
- leukoencephalopathy
- leukopenia
- maculopapular rash
- memory impairment
- muscle paralysis
- myalgia
- nausea
- neuritis
- nystagmus
- ocular hemorrhage
- oral ulceration
- pancreatitis
- pancytopenia
- pericarditis
- peripheral neuropathy
- phlebitis
- pneumatosis cystoides intestinalis
- pneumonitis
- pruritus
- psychosis
- pulmonary edema
- rash
- respiratory arrest
- seizures
- teratogenesis
- thrombocytopenia
- tremor
- tumor lysis syndrome (TLS)
- urinary retention
- urticaria
- vomiting
Monitoring Parameters
- CBC with differential
- LFTs
Contraindications
- abdominal pain
- accidental exposure
- anemia
- benzyl alcohol hypersensitivity
- bone marrow suppression
- breast-feeding
- chemotherapy-induced nausea/vomiting
- children
- dental disease
- dental work
- diarrhea
- geriatric
- hepatic disease
- hepatotoxicity
- herpes infection
- hyperkalemia
- hyperphosphatemia
- hyperuricemia
- hypocalcemia
- infection
- intramuscular injections
- leukopenia
- neonates
- neurological disease
- ocular exposure
- oral ulceration
- pregnancy
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- thrombocytopenia
- tumor lysis syndrome (TLS)
- vaccination
- varicella
- viral infection
Interactions
- Amlodipine; Celecoxib
- Anticoagulants
- Antithrombin III
- Apixaban
- Argatroban
- Asparaginase Erwinia chrysanthemi
- Betrixaban
- Bivalirudin
- Celecoxib
- Clofarabine
- Cyclophosphamide
- Dabigatran
- Dalteparin
- Danaparoid
- Desirudin
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Edoxaban
- Enoxaparin
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flucytosine
- Fludarabine
- Flurbiprofen
- Fondaparinux
- Gentamicin
- Heparin
- Hydrocodone; Ibuprofen
- Hydroxyurea
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Ketoprofen
- Ketorolac
- L-Asparaginase Escherichia coli
- Lansoprazole; Naproxen
- Lepirudin
- Live Vaccines
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methotrexate
- Mitoxantrone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Pegaspargase
- Penicillamine
- Pentosan
- Piroxicam
- Rivaroxaban
- Rofecoxib
- Sulindac
- Tinzaparin
- Tolmetin
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
- Warfarin
