Cytara

Introduction
Cytara is used to treat some kinds of cancers of blood. It may be also used to treat other conditions, as determined by the doctor. It is sometimes used with certain other medicines as part of combination chemotherapy. Cytara is given as an injection into the vein or under skin by the healthcare professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. The most common side effects of this medicine include rash, skin ulcer, nausea, vomiting, and hair loss. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections or bleeding. Inform your doctor if you notice chills, unusual bleeding or bruising and black and tarry stools. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels. Before taking it, tell your doctor if you have bleeding, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.

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Uses of Cytara
Blood cancer
Side effects of Cytara
Common
Rash
Skin ulcer
Nausea
Vomiting
Hair loss
Abdominal pain
Anal ulcers
Anemia (low number of red blood cells)
Decreased white blood cell count
Fever
Infection
Abnormal liver function
Low blood platelets
Mouth ulcer
Pneumonia
Sepsis
Mouth sore
Stomatitis (Inflammation of the mouth)
How to use Cytara
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Cytara works
Cytara interferes with the growth of DNA and RNA of the cancer cells by substituting their building blocks. It prevents the cancer cells from growing and multiplying.
Quick Tips
Use a reliable contraceptive method to prevent pregnancy while you are taking this medicine.
Inform your doctor immediately if you notice any signs of infection such as fever, sore throat, rash or severe diarrhea.
Brief Description
Indication
Acute myeloid leukaemia, acute lymphocytic leukaemia (ALL), lymphomas, Leukaemic meningitis

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Administration
IV Administration Rapid IV, infusion over 1-3 hr, or SC intrathecal Has been administered by IM & continuous SC infusion IT: Patient should lie flat for 1 hour after lumbar puncture Liposomal: To reduce incidence of arachnoiditis, administer dexamethasone concurrently IV Preparation Reconstitute vials in BWI containing benzyl alcohol 0.945% as follows (CAUTION: Do not use benzyl alcohol for intrathecal inj) 100 mg vial: add 5 mL diluent to 20 mg/mL 500 mg vial: add 10 mL diluent to 50 mg/mL 1 g vial: add 10 mL diluent to 100 mg/mL 2 g vial: add 20 mL diluent to 100 mg/mL

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Adult Dose
Acute Nonlymphocytic Leukemia IV administration for remission induction 100-200 mg/sq.meter/day for 5-10 days; begin second course in 2-4 weeks after initial therapy if necessary OR 100 mg/sq.meter for 7 days OR 100 mg/sq.meter/dose q12hr for 7 days Intrathecal (IT) administration for remission induction 5-75 mg/sq.meter q2-7Days until CNS findings normalize IV administration for remission maintenance 70-200 mg/sq.meter/day for 2-5 days at monthly intervals IM administration for remission maintenance 1-1.5 mg/kg single dose for maintenance at 1- 4 week intervals Meningeal Leukemia IT administration 30 mg/sq.meter intrathecal (IT) q4Days until CSF findings normal plus one additional dose Refractory Leukemia IV administration 3 g/sq.meter IV (infusion over 1-3 hours) q12hr x 4-12 doses Repeat q2-3Weeks

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Contraindication
Hypersensitivity; pregnancy and lactation.
Mode of Action
Cytarabine acts by interfering with DNA synthesis specifically at the S-phase of the cell cycle. It is a potent myelosuppressant and requires careful haematological monitoring during its use. It also has antiviral property.
Precaution
Hepatic and renal dysfunction, severe infections, preexisting drug-induced bone marrow suppression. Monitor WBC, platelet counts and blood uric acid frequently. Assess renal and hepatic function periodically. Lactation: not known if excreted in breast milk, avoid

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Side Effect
1-10% Anorexia,Nausea,Vomiting,Diarrhea,Oral/anal inflammation,Thrombophlebitis,Bleeding,Myelosuppression,Rash,Fever,Hepatic dysfunction Frequency Not Defined Headache,Neuropathy,Chest pain,Pericarditis,Pneumonia,Anemia,Bleeding,Leukopenia,Thrombocytopenia,Kidney disease,Infectious disease,Sepsis,”Cytarabine syndrome”: fever, myalgia, bone pain, rash, conjunctivitis, malaise,Skin ulcers,Cellulitis,Urinary retention,Neuritis,Jaundice,Anaphylaxis Potentially Fatal: Convulsions. Cerebellar dysfunction, respiratory distress syndrome, GI perforation, bone marrow suppression.

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Pregnancy Category Note
Pregnancy Category: D Lactation: not known if excreted in breast milk, avoid

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Interaction
May reduce efficacy of gentamicin, digoxin and flucytosine. Potentially Fatal: Potentiates bone marrow depression with radiotherapy and other myelotoxic drugs.

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