Cytarabine

Last updated on RxList: 7/13/2020
Cytarabine Side Effects Center

What Is Cytarabine?

Cytarabine for Injection (Brand Names: Cytosar-U, Tarabine PFS) is a cancer medication used to treat certain types of leukemia (blood cancers). Cytarabine is also used to treat leukemia associated with meningitis. Cytarabine is available in generic form.

What Are Side Effects of Cytarabine?

Common side effects of Cytarabine include:

  • nausea and vomiting (may be severe),
  • loss of appetite,
  • diarrhea,
  • constipation,
  • headache,
  • dizziness,
  • injection site reactions (pain, swelling, and redness),
  • drowsiness,
  • weakness,
  • memory problems,
  • back pain,
  • pain in your arms or legs, or
  • trouble sleeping (insomnia)

Dosage for Cytarabine

Cytarabine may be given by intravenous infusion or injection, subcutaneously, or intrathecally. Dose is determined by a physician. Cytarabine may interact with digoxin.

What Drugs, Substances, or Supplements Interact with Cytarabine?

Other drugs may interact with cytarabine. Tell your doctor all prescription and over-the-counter medications and supplements you use.

Cytarabine During Pregnancy and Breastfeeding

Cytarabine is not recommended for use during pregnancy. It may harm a fetus, especially in the first 3 months of pregnancy. It is recommended that men and women use two forms of birth control (e.g., condoms, birth control pills) while taking this medication and for some period afterwards. Consult your doctor. It is unknown if this drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended.

Additional Information

Our Cytarabine Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Cytarabine Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Cytarabine can cause serious side effects on your brain or central nervous system that may not be reversible. Cytarabine is usually given together with steroid medicine to help lessen these side effects.

Call your doctor at once if you have:

  • severe drowsiness, confusion, unusual thoughts or behavior;
  • fever, chills, body aches, feeling very ill;
  • stomach pain, bloating, nausea, vomiting, bloody or tarry stools;
  • loss of movement in any part of your body;
  • liver problems--loss of appetite, right-sided upper stomach pain, dark urine, jaundice (yellowing of the skin or eyes);
  • low platelets or red blood cells--pale skin, easy bruising, unusual bleeding, tiredness, feeling light-headed, cold hands and feet;
  • lung problems--pain when you breathe, shortness of breath while lying down, cough with foamy mucus; or
  • signs of eye infection--swelling, redness, severe discomfort, crusting or drainage;

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

  • liver problems;
  • fever;
  • bleeding;
  • nausea, vomiting, diarrhea;
  • mouth sores;
  • rectal pain or sores;
  • rash; or
  • bruising where medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Cytarabine (Cytarabine)

Cytarabine Professional Information

SIDE EFFECTS

Expected Reactions

Because cytarabine is a bone marrow suppressant, anemia, leukopenia, thrombocytopenia, megaloblastosis and reduced reticulocytes can be expected as a result of administration with cytarabine. The severity of these reactions are dose and schedule dependent. Cellular changes in the morphology of bone marrow and peripheral smears can be expected.

Following 5-day constant infusions or acute injections of 50 mg/m2 to 600 mg/m2 , white cell depression follows a biphasic course. Regardless of initial count, dosage level, or schedule, there is an initial fall starting the first 24 hours with a nadir at days 7 to 9. This is followed by a brief rise which peaks around the twelfth day. A second and deeper fall reaches nadir at days 15 to 24. Then there is a rapid rise to above baseline in the next 10 days. Platelet depression is noticeable at 5 days with a peak depression occurring between days 12 to 15. Thereupon, a rapid rise to above baseline occurs in the next 10 days.

Infectious Complications

Injection

Viral, bacterial, fungal, parasitic, or saprophytic infections, in any location in the body may be associated with the use of cytarabine alone or in combination with other immunosuppressive agents following immunosuppressant doses that affect cellular or humoral immunity. These infections may be mild, but can be severe and at times fatal.

The Cytarabine (Ara-C) Syndrome

A cytarabine syndrome has been described by Castleberry. It is characterized by fever, myalgia, bone pain, occasionally chest pain, maculopapular rash, conjunctivitis and malaise. It usually occurs 6 to 12 hours following drug administration. Corticosteroids have been shown to be beneficial in treating or preventing this syndrome. If the symptoms of the syndrome are deemed treatable, corticosteroids should be contemplated as well as continuation of therapy with cytarabine.

Most Frequent Adverse Reactions
AnorexiaOral and anal inflammation or ulcerationRash
NauseaThrombophlebitis
VomitingHepatic dysfunctionBleeding (all sites)
DiarrheaFever
Nausea and vomiting are most frequent following rapid intravenous injection.

Less Frequent Adverse Reactions
SepsisSore throatConjunctivitis (may occur with rash)
PneumoniaEsophageal ulcerationDizziness
Cellulitis at injection siteEsophagitisAlopecia
Skin ulcerationChest painAnaphylaxis (see WARNING)
Urinary retentionPericarditisAllergic edema
Renal dysfunctionBowel necrosisPruritus
NeuritisAbdominal painShortness of breath
Neural toxicityPancreatitisUrticaria
FrecklingHeadache
Jaundice

Experimental Doses

Severe and at times fatal CNS, GI and pulmonary toxicity (different from that seen with conventional therapy regimens of cytarabine) has been reported following some experimental dose schedules of cytarabine. These reactions include reversible corneal toxicity and hemorrhagic conjunctivitis, which may be prevented or diminished by prophylaxis with a local corticosteroid eye drop; cerebral and cerebellar dysfunction, including personality changes, somnolence and coma, usually reversible; severe gastrointestinal ulceration, including pneumatosis cystoides intestinalis leading to peritonitis; sepsis and liver abscess; pulmonary edema, liver damage with increased hyperbilirubinemia; bowel necrosis; and necrotizing colitis. Rarely, severe skin rash, leading to desquamation has been reported. Complete alopecia is more commonly seen with experimental high dose therapy than with standard treatment programs using cytarabine. If experimental high dose therapy is used, do not use a preparation containing benzyl alcohol.

Cases of cardiomyopathy with subsequent death have been reported following experimental high dose therapy with cytarabine in combination with cyclophosphamide when used for bone marrow transplant preparation.

This Cardiac Toxicity May Be Schedule Dependent.

A syndrome of sudden respiratory distress, rapidly progressing to pulmonary edema and radiographically pronounced cardiomegaly has been reported following experimental high dose therapy with cytarabine used for the treatment of relapsed leukemia from one institution in 16/72 patients. The outcome of this syndrome can be fatal.

Two patients with adult acute non-lymphocytic leukemia developed peripheral motor and sensory neuropathies after consolidation with high-dose cytarabine, daunorubicin, and asparaginase. Patients treated with high-dose cytarabine should be observed for neuropathy since dose schedule alterations may be needed to avoid irreversible neurologic disorders.

Ten patients treated with experimental intermediate doses of cytarabine (1 g/m2 ) with and without other chemotherapeutic agents (meta-AMSA, daunorubicin, etoposide) at various dose regimes developed a diffuse interstitial pneumonitis without clear cause that may have been related to the cytarabine.

Two cases of pancreatitis have been reported following experimental doses of cytarabine and numerous other drugs. Cytarabine could have been the causative agent.

Read the entire FDA prescribing information for Cytarabine (Cytarabine)

© Cytarabine Patient Information is supplied by Cerner Multum, Inc. and Cytarabine Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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