cytarabine at a glance
Medicine class
Cytotoxic antimetabolite; pyrimidine analogue.
Main role
Treatment of acute leukaemias and selected other haematological cancers.
Administration
Given by intravenous or subcutaneous injection; the selected formulation is not suitable for intrathecal use.
Key monitoring
Regular blood counts and checks of liver, kidney and uric acid levels are required.
What is cytarabine used for?
The selected UK product is licensed for remission induction or maintenance, alone or with other antineoplastic agents, in several blood and meningeal cancers.
Acute myeloid and other acute non-lymphoblastic leukaemias
Acute lymphoblastic or lymphocytic leukaemia
Erythroleukaemia
Blast crisis of chronic myeloid leukaemia
High-grade non-Hodgkin lymphoma described in the licence as diffuse histiocytic lymphoma
Meningeal leukaemia and meningeal neoplasms
How does cytarabine work?
Inside cells, cytarabine is converted to an active nucleotide that competes with normal DNA building blocks and inhibits DNA polymerase. Its main effect occurs during the DNA-copying phase of the cell cycle, limiting the growth of rapidly dividing cancer cells while also affecting healthy bone-marrow and gastrointestinal cells.
cytarabine preparations and strengths
Injection
Route: Parenteral
Strengths: 20 mg/mL, 100 mg/mL
How to take cytarabine
Cytarabine is given by trained healthcare professionals into a vein or under the skin. Subcutaneous treatment may occasionally be supplied for home administration after specific training; use only the equipment and disposal arrangements provided by the treatment team. The selected formulation must not be injected into spinal fluid.
Follow the oncology team's instructions for appointments, line care and home injections.
Do not mix, alter or dispose of cytarabine in household waste.
Report pain, redness, swelling or leakage around an injection or infusion site promptly.
cytarabine side effects
Common or expected effects
- Reduced blood-cell production, which may cause infection risk, anaemia, bruising or bleeding
- Nausea, vomiting, diarrhoea or abdominal discomfort
- Sore mouth, ulcers or difficulty swallowing
- Fever or flu-like symptoms
- Rash, skin changes or temporary hair loss
- Eye irritation or inflammation, particularly with more intensive treatment
- Injection-site inflammation
- Reduced appetite or altered liver-test results
Get urgent medical advice
- Severe infection or sepsis associated with low white-cell counts
- Serious bleeding associated with low platelets
- Severe allergic reaction
- New neurological problems such as confusion, slurred speech, poor coordination, marked drowsiness or seizures
- Severe breathing difficulty, lung inflammation or pulmonary oedema
- Severe abdominal pain, bowel inflammation, bleeding or perforation
- Serious eye pain or visual disturbance
- Chest pain or significant heart problems
cytarabine in pregnancy
Cytarabine can harm a developing baby and should generally be avoided in pregnancy, particularly during the first trimester, unless specialists judge that the potential benefit outweighs the risk. Pregnancy during treatment requires urgent discussion between haematology and specialist maternity teams. Highly effective contraception is advised during treatment and afterwards for the product-specific period given by the oncology team.
cytarabine while breastfeeding
Breastfeeding should stop during cytarabine treatment and for at least one week after the final administration. Evidence about transfer into human milk is very limited, so the oncology and infant-care teams should confirm when restarting is appropriate.
cytarabine interactions
The treatment team should review prescribed, non-prescription and complementary products before cytarabine is given.
Methotrexate
Combined treatment may increase the risk of encephalopathy and requires careful neurological assessment.
Digoxin
Combination chemotherapy containing cytarabine may reduce absorption of oral digoxin, so clinical response and blood concentrations may need review.
Flucytosine
Cytarabine may abolish its antifungal effectiveness, so concomitant use should be avoided.
Gentamicin
Laboratory evidence suggests reduced activity against Klebsiella pneumoniae; inadequate clinical response should prompt reassessment of antibacterial therapy.
Common questions about cytarabine
Answers are fully visible for fast scanning and source review.
What type of chemotherapy is cytarabine?
It is an antimetabolite chemotherapy and pyrimidine analogue that interferes with DNA synthesis.
How is cytarabine administered?
It may be injected or infused into a vein or injected under the skin, depending on the product and treatment plan.
Can the selected cytarabine injection be given into spinal fluid?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.