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Fludarabine Brand Names- Fludara | Oforta
What is Fludarabine
Fludarabine is a purine nucleoside antineoplastic agent indicated for the treatment of adult patients with B-cell chronic lymphocytic leukemia who have not responded to or whose disease has progressed during treatment with at least 1 standard alkylating agent-containing regimen.
Life-threatening or fatal autoimmune reactions (e.g., hemolytic anemia, thrombocytopenic purpura, and acquired hemophilia) have been reported with fludarabine therapy; monitor patients for hemolysis.
Indications
- acute myelogenous leukemia (AML)
- chronic lymphocytic leukemia (CLL)
- cutaneous T-cell lymphoma (CTCL)
- mycosis fungoides
- non-Hodgkin’s lymphoma (NHL)
- prolymphocytic leukemia (PLL)
- stem cell transplant preparation
For the treatment of chronic lymphocytic leukemia (CLL)
for the treatment of B-cell CLL in patients who have not responded to or whose disease has progressed during treatment with at least 1 standard alkylating agent-containing regimen
NOTE: Fludarabine has been designated an orphan drug by the FDA for B-cell CLL and refractory CLL.
Side Effects
- acute cerebellar syndrome
- acute respiratory distress syndrome (ARDS)
- agitation
- alopecia
- anaphylactoid reactions
- anemia
- angina
- anorexia
- arthralgia
- bleeding
- bone marrow suppression
- chills
- cholelithiasis
- coma
- confusion
- constipation
- cough
- dehydration
- depression
- diaphoresis
- diarrhea
- dysphagia
- dyspnea
- dysuria
- edema
- elevated hepatic enzymes
- epistaxis
- erythema multiforme
- esophagitis
- fatigue
- fever
- GI bleeding
- headache
- hearing loss
- heart failure
- hematuria
- hemolysis
- hemolytic anemia
- hemoptysis
- hemorrhagic cystitis
- hepatic failure
- hyperamylasemia
- hyperglycemia
- hyperkalemia
- hyperphosphatemia
- hyperuricemia
- hypocalcemia
- hypoxia
- infection
- intracranial bleeding
- leukoencephalopathy
- malaise
- metabolic acidosis
- myalgia
- myocardial infarction
- nausea
- nephrolithiasis
- neurotoxicity
- neutropenia
- new primary malignancy
- optic neuritis
- osteoporosis
- pancytopenia
- paresthesias
- pemphigus
- pericardial effusion
- peripheral neuropathy
- pharyngitis
- phlebitis
- pneumonitis
- proteinuria
- pruritus
- pulmonary fibrosis
- purpura
- rash
- renal failure (unspecified)
- respiratory depression
- seborrhea
- seizures
- sinusitis
- Stevens-Johnson syndrome
- stomatitis
- stroke
- supraventricular tachycardia (SVT)
- thrombocytopenia
- thrombosis
- toxic epidermal necrolysis
- tumor lysis syndrome (TLS)
- visual impairment
- vomiting
- weakness
Monitoring Parameters
- CBC with differential
- LDH
- red blood cell count (RBC)
- reticulocyte count
- serum bilirubin
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
Contraindications
- anemia
- autoimmune disease
- bone marrow suppression
- breast-feeding
- coma
- contraception requirements
- driving or operating machinery
- hemolytic anemia
- hemophilia
- herpes infection
- immune thrombocytopenic purpura (ITP)
- infection
- infertility
- male-mediated teratogenicity
- neurotoxicity
- neutropenia
- pregnancy
- pulmonary toxicity
- renal impairment
- reproductive risk
- requires an experienced clinician
- seizures
- thrombocytopenia
- tumor lysis syndrome (TLS)
- use with pentostatin
- vaccination
- viral infection
- visual disturbance
Interactions
- Alpha interferons
- Antithymocyte Globulin
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Basiliximab
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Carbamazepine
- Ciclesonide
- Clozapine
- Corticosteroids
- Cortisone
- Cyclosporine
- Cytarabine, ARA-C
- Deflazacort
- Dexamethasone
- Diclofenac
- Diclofenac; Misoprostol
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Echinacea
- Efalizumab
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Febuxostat
- Fenoprofen
- Filgrastim, G-CSF
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Influenza Virus Vaccine
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Intranasal Influenza Vaccine
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Live Vaccines
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methotrexate
- Methylprednisolone
- Mometasone
- Muromonab-CD3
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Oxaprozin
- Palifermin
- Pegfilgrastim
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Penicillamine
- Pentostatin
- Pentoxifylline
- Piroxicam
- Platelet Inhibitors
- Prednisolone
- Prednisone
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Sulindac
- Tbo-Filgrastim
- Tolmetin
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Typhoid Vaccine
- Varicella-Zoster Virus Vaccine, Live
- Yellow Fever Vaccine, Live
