section name header

Indications

High Alert

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: edema.

Derm: alopecia, rash.

EENT: corneal toxicity (high dose), hemorrhagic conjunctivitis (high dose), visual disturbances (including blindness).

GI: nausea, vomiting, GI ulceration (high dose), HEPATOTOXICITY, stomatitis.

GU: sterility, urinary incontinence.

Hemat: (less with IT use): anemia, leukopenia, thrombocytopenia.

Metab: hyperuricemia.

Neuro: IT: abnormal gait, CHEMICAL ARACHNOIDITIS, CNS dysfunction (high dose), confusion, drowsiness, headache.

Resp: PULMONARY EDEMA (HIGH DOSE).
Misc: cytarabine syndrome, fever.

Interactions

Drug-Drug:

Availability

(Generic available)

Route/Dosage

see Calculator

Dose regimens vary widely

US Brand Names

Cytosar-U

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antineoplastics

Pharmacologic Classification: antimetabolites

Pharmacokinetics

Absorption: Absorption occurs from SUBQ sites, but blood levels are lower than with IV administration; IT administration results in negligible systemic exposure.

Distribution: Widely distributed; IV- and SUBQ-administered cytarabine crosses the blood-brain barrier but not in sufficient quantities.

Metabolism/Excretion: Metabolized mostly by the liver; <10% excreted unchanged by the kidneys. Metabolism to inactive drug in the CSF is negligible because the enzyme that metabolizes it is present in very low concentrations in the CSF.

Half-life: IV, SUBQ: 1–3 hr; IT: 100–236 hr.

Time/Action Profile

(IV, SUBQ — effects on WBCs; IT — levels in CSF)

ROUTEONSETPEAKDURATION
SUBQ, IV (1st phase)24 hr7–9 days12 days
SUBQ, IV (2nd phase)15–24 days15–24 days25–34 days
ITrapid5 hr14–28 days

Patient/Family Teaching

Pronunciation

sye-TARE-a-been