Cytarabine

Mechanism :

Cytarabine is a cell cycle phase-specific antineoplastic agent, affecting cells only during the S-phase of cell division. Intracellularly, cytarabine is converted into cytarabine-5-triphosphate, which is the active metabolite. The mechanism of action is not completely understood, but it appears that Ara-CTP acts primarily through inhibition of DNA polymerase.

Indication :

• Acute lymphoblastic leukemia
• Acute myeloid leukemia
• Non-Hodgkin’s lymphoma

Contraindications :

Known hypersensitivity to the drug is a contraindication to its use.

Since Cytarabine is a potent bone marrow suppressant, it should be used cautiously in patients with pre-existing drug-induced bone marrow suppression, impaired liver function. Cytarabine may induce hyperuricemia due to rapid lysis of neoplastic cells.

Dosing :

Adverse Effect :

Quadriplegia and paralysis with intrathecal administration. Myelosuppression (megaloblastosis, reticulocytopenia, thrombocytopenia and anemia), nausea, vomiting, diarrhea, anorexia, oral and anal ulceration, sore throat, esophagitis, oesophageal ulceration and gastrointestinal haemorrhage, fever, rash, alopecia, skin ulceration, conjunctivitis, chest pain, urinary retention, dizziness, neuritis, cellulitis or thrombophlebitis at the site of injection.

Cytarabine reaction: Cytarabine syndrome/reaction is characterized by fever, myalgia, bone pain, occasionally chest pain, maculopapular rash, conjunctivitis and malaise. It usually occurs 6-12 hours after administration.

Interaction :

Digoxin: Absorption of oral digoxin may be substantially reduced.
Gentamicin, Flucytosine: Cytarabine may antagonize activity.

Renal Dose :

Hepatic Dose :