Conventional Formulation - Prior to Initiation of Therapy
- Only physicians experienced in cancer chemotherapy should use cytarabine injection.
- For induction therapy, patients should be treated in a facility with laboratory and supportive resources sufficient to monitor drug tolerance and protect and maintain a patient compromised by drug toxicity. The main toxic effect of cytarabine injection is bone marrow suppression with leukopenia, thrombocytopenia, and anemia. Less serious toxicity includes nausea, vomiting, diarrhea, and abdominal pain, oral ulceration, and hepatic dysfunction.
- The physician must judge possible benefit to the patient against known toxic effects of this drug in considering the advisability of therapy with cytarabine injection. Before making this judgment or beginning treatment, the physician should be familiar with the package insert information.
MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA
- Conventional Formulation:Patients receiving this drug must be under close medical supervision and, during induction therapy, should have leucocyte and platelet counts performed daily.
- Bone marrow examinations should be performed frequently after blasts have disappeared from the peripheral blood.
- Facilities should be available for management of complications, possibly fatal, of bone marrow suppression (infection resulting from granulocytopenia and other impaired body defenses, and hemorrhage secondary to thrombocytopenia.
Updated January 2018