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cytarabine
generic
Black Box Warnings .
Appropriate Use
admin. only under supervision of physician experienced in cancer chemotherapy; physician should weigh benefit vs. toxicity risk and be familiar w/ complete prescribing information before use; admin. induction tx in adequate medical facility to monitor and manage toxicity
Toxicity
primarily myelosuppression w/ leukopenia, thrombocytopenia, and anemia; less serious events incl. nausea, vomiting, diarrhea, abdominal pain, oral ulcer, hepatic impairment
Adult Dosing .
Dosage forms: INJ
Special Note
- [formulation clarification]
- Info: not interchangeable w/ liposomal cytarabine-containing products
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
AML
- [induction tx, standard-dose regimen]
- Dose: 100 mg/m^2/24h IV infusion on days 1-7 of cycle; Alt: 100 mg/m^2/dose IV q12h on days 1-7 of cycle; 200 mg/m^2/24h IV infusion on days 1-7 of cycle; Info: use w/ anthracycline or part of multi-drug chemo regimen
- [consolidation tx, high-dose regimen, <60 yo (off-label)]
- Dose: 3000 mg/m^2/dose IV q12h on days 1, 3, 5 of each cycle; Info: give x3-4 cycles
- [consolidation tx, standard-dose regimen, >60 yo (off-label)]
- Dose: 100-200 mg/m^2/24h IV infusion on days 1-7 of each cycle; Alt: 100-200 mg/m^2/24h IV infusion on days 1-5 of each cycle; Info: use as monotherapy or w/ anthracycline; give up to 2 cycles
- [low-dose regimen, combo w/ glasdegib (off-label)]
- Dose: 20 mg SC bid on days 1-10 of 28-days cycle; Info: for pts 75 yo and older, or who are ineligible for intensive induction chemo d/t comorbidities; give for at least 6 cycles
- [low-dose regimen, combo w/ venetoclax (off-label)]
- Dose: 20 mg SC qd on days 1-10 of 28-days cycle; Info: for pts 75 yo and older, or who are ineligible for intensive induction chemo d/t comorbidities; cytoreduction may be required if WBC >25,000 prior to 1st dose
meningeal leukemia
- [30 mg/m^2/dose intrathecally q4 days]
- Info: for prevention and tx; cont. until CSF normal, then give x1 additional dose
renal dosing
- [standard or low-dose regimen]
- renal impairment: no adjustment
- HD/PD: not defined
- [high-dose regimen]
- CrCl 46-60: decr. usual dose by 40%; CrCl 31-45: decr. usual dose by 50%; CrCl <30: consider alternate tx
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: consider decr. usual dose
Peds Dosing .
- Dosage forms: INJ
Special Note
- [formulation clarification]
- Info: not interchangeable w/ liposomal cytarabine-containing products
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
AML, induction
- [100 mg/m^2/24h IV infusion on days 1-7 of cycle]
- Alt: 100 mg/m^2/dose IV q12h on days 1-7 of cycle; Info: part of multi-drug chemo regimen
meningeal leukemia
- [30 mg/m^2/dose intrathecally q4 days]
- Info: for prevention and tx; cont. until CSF normal, then give one additional dose
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: consider decr. usual dose