clofarabine

Contraindicated in:

OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Renal impairment;
Hepatic impairment;
Infection, sepsis, or tumor lysis syndrome (↑ risk of acute renal failure).

Adv. Reactions/Side Effects ⬆ ⬇

CV: pericardial effusion, tachycardia, edema

Derm: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

EENT: pharyngitis

F and E: dehydration

GI: diarrhea, nausea, abdominal pain, constipation, ENTEROCOLITIS, HEPATOTOXICITY, mucositis, vomiting

GU: hematuria, acute renal failure

Hemat: bleeding, neutropenia, anemia, thrombocytopenia

Local: injection site pain

Neuro: fatigue

Misc: infection, chills, fever, SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS), TUMOR LYSIS SYNDROME

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of hepatotoxic or nephrotoxic drugs↑ risk of hepatotoxicity and nephrotoxicity and should be avoided for the 5-day treatment period.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 1 mg/mL

Route/Dosage ⬆ ⬇

IV (Children 1–21 yr): 52 mg/m² daily for 5 days; cycle may be repeated every 2–6 wk.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Converted intracellularly to the active 5'-triphosphate metabolite, which acts as a purine nucleoside antimetabolite; net result is inhibition of DNA synthesis.
Produces a rapid reduction of peripheral leukemia cells.

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: antimetabolites

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: 46–60% excreted unchanged in urine.

Half-Life: 5.2 hr.

Time/Action Profile ⬆ ⬇

(effect on WBCs)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	unknown	2–6 wk

Patient/Family Teaching ⬆ ⬇

Explain purpose of clofarabine to patient.
Advise patient to notify health care professional if signs and symptoms of hematologic toxicity (weakness, fatigue, pallor, shortness of breath, easy bruising, petechiae, purpura, fever), infection (fever), SIRS/capillary leak syndrome (fever, tachycardia, tachypnea, dyspnea, hypotension), and rash occur.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during and for 6 mo after last dose and to avoid breastfeeding during and for at least 2 wk after last dose of therapy. Advise males with female partners of reproductive potential to use effective contraception during and for at least 3 mo after last dose of therapy. May impair female and male fertility.

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇