Nelarabine

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Nelarabine Brand Name– Arranon

What is Nelarabine

Nelarabine is a cytotoxic purine nucleoside analog. It is indicated for the treatment of T-cell acute lymphoblastic leukemia (ALL) and T-cell lymphoblastic lymphoma in pediatric patients 1 year of age or older and adults with relapsed or refractory disease following at least 2 prior chemotherapy regimens.

Severe neurologic adverse reactions have been reported with nelarabine therapy; therefore, monitor patients closely.

Indications

  • chronic lymphocytic leukemia (CLL)
  • T-cell leukemia/lymphoma

For the treatment of T-cell leukemia/lymphoma

NOTE: The FDA has designated nelarabine as an orphan drug for the treatment of acute lymphoblastic leukemia and lymphoblastic lymphoma.

for the treatment of relapsed or refractory T-cell acute lymphoblastic leukemia (ALL) or T-cell lymphoblastic lymphoma following at least 2 prior chemotherapy regimens

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. amnesia
  4. anemia
  5. anemia
  6. anorexia
  7. aphasia
  8. arthralgia
  9. arthralgia
  10. asthenia
  11. asthenia
  12. ataxia
  13. ataxia
  14. back pain
  15. blurred vision
  16. chest pain (unspecified)
  17. chills
  18. coma
  19. confusion
  20. confusion
  21. constipation
  22. constipation
  23. cough
  24. dehydration
  25. dehydration
  26. depression
  27. depression
  28. diarrhea
  29. diarrhea
  30. dizziness
  31. drowsiness
  32. drowsiness
  33. dysarthria
  34. dysesthesia
  35. dysgeusia
  36. dyspnea
  37. dyspnea
  38. edema
  39. elevated hepatic enzymes
  40. elevated hepatic enzymes
  41. encephalopathy
  42. epistaxis
  43. fatigue
  44. fatigue
  45. fever
  46. fever
  47. Guillain-Barre syndrome
  48. headache
  49. headache
  50. hydrocephalus
  51. hyperbilirubinemia
  52. hyperbilirubinemia
  53. hyperglycemia
  54. hyperglycemia
  55. hypertonia
  56. hyperuricemia
  57. hypoalbuminemia
  58. hypoalbuminemia
  59. hypocalcemia
  60. hypocalcemia
  61. hypoesthesia
  62. hypoesthesia
  63. hypoglycemia
  64. hypoglycemia
  65. hypokalemia
  66. hypokalemia
  67. hypomagnesemia
  68. hypomagnesemia
  69. hyporeflexia
  70. hypotension
  71. hypotension
  72. infection
  73. infection
  74. insomnia
  75. intracranial bleeding
  76. lethargy
  77. leukoencephalopathy
  78. leukopenia
  79. leukopenia
  80. muscle paralysis
  81. myalgia
  82. myalgia
  83. nausea
  84. neuropathic pain
  85. neurotoxicity
  86. neurotoxicity
  87. neutropenia
  88. neutropenia
  89. nystagmus
  90. paresis
  91. paresthesias
  92. paresthesias
  93. peripheral edema
  94. peripheral neuropathy
  95. peripheral neuropathy
  96. petechiae
  97. petechiae
  98. pleural effusion
  99. pneumothorax
  100. rhabdomyolysis
  101. seizures
  102. sinus tachycardia
  103. sinus tachycardia
  104. sinusitis
  105. sinusitis
  106. stomatitis
  107. stomatitis
  108. thrombocytopenia
  109. thrombocytopenia
  110. tremor
  111. tumor lysis syndrome (TLS)
  112. vomiting
  113. vomiting
  114. weakness
  115. weakness
  116. wheezing

Monitoring Parameters

  • CBC with differential
  • neurologic function
  • pregnancy testing
  • serum creatinine
  • serum electrolytes
  • serum uric acid

Contraindications

  • anemia
  • breast-feeding
  • children
  • contraception requirements
  • driving or operating machinery
  • geriatric
  • hepatic disease
  • hyperuricemia
  • male-mediated teratogenicity
  • neurologic events
  • neurotoxicity
  • neutropenia
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • renal disease
  • renal impairment
  • reproductive risk
  • thrombocytopenia
  • tumor lysis syndrome (TLS)
  • vaccination

Interactions

  • Abciximab
  • Amlodipine; Celecoxib
  • Anagrelide
  • Anticoagulants
  • Aspirin, ASA; Dipyridamole
  • Azelastine; Fluticasone
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Beclomethasone
  • Betamethasone
  • Budesonide
  • Budesonide; Formoterol
  • Celecoxib
  • Ciclesonide
  • Cilostazol
  • Clopidogrel
  • Clozapine
  • Corticosteroids
  • Cortisone
  • Deflazacort
  • Dexamethasone
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Eptifibatide
  • 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
  • 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
  • Methylprednisolone
  • Mometasone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Penicillamine
  • Piroxicam
  • Platelet Inhibitors
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Rofecoxib
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Sulindac
  • Tbo-Filgrastim
  • Ticagrelor
  • Ticlopidine
  • Tirofiban
  • Tolmetin
  • Triamcinolone
  • Tuberculin Purified Protein Derivative, PPD
  • Typhoid Vaccine
  • Valdecoxib
  • Varicella-Zoster Virus Vaccine, Live
  • Vorapaxar
  • Yellow Fever Vaccine, Live

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