CNS: dizziness, fatigue.
Derm: acute febrile neutrophilic dermatosis, ecchymosis.
F and E: hypokalemia.
GI: abdominal pain, constipation, ↓appetite, diarrhea, nausea, vomiting, HEPATOTOXICITY.
GU: ↓fertility, NEPHROTOXICITY, renal tubular acidosis.
Hemat: anemia, neutropenia, thrombocytopenia.
Local: injection site erythema.
MS: arthralgia.
Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), TUMOR LYSIS SYNDROME.
Do NOT interchange/substitute parenteral product with oral formulation.
Myelodysplastic Syndromes
- SC, IV (Adults): 75 mg/m2once daily on Days 1–7 of each 28–day cycle; if no beneficial effect occurs after two cycles and if no toxicity other than nausea or vomiting has occurred, may ↑ to 100 mg/m2 once daily on Days 1–7 of each 28–day cycle. Continue for as long as patient benefits (minimum of 4–6 cycles recommended).
Juvenile Myelomonocytic Leukemia
- IV (Children
1 yr and 10 kg): 75 mg/m2once daily on Days 1–7 of each 28–day cycle. Continue for at least 3 cycles and a maximum of 6 cycles (as long as patient continues to benefit). - IV (Children 1 mo-<1 yr or <10 kg): 2.5 mg/kg once daily on Days 1–7 of each 28–day cycle. Continue for at least 3 cycles and a maximum of 6 cycles (as long as patient continues to benefit).
Acute Myeloid Leukemia
- PO (Adults): 300 mg once daily on Days 1–14 of each 28–day cycle; continue until disease progression or unacceptable toxicity.
Therapeutic Classification: antineoplastics
Pharmacologic Classification: nucleoside analogues
Absorption: IV administration results in complete bioavailability; 89% absorbed following subcutaneous administration; bioavailability of oral administration 11% relative to subcutaneous administration.
Distribution: Widely distributed to extravascular tissues.
Metabolism/Excretion: 85% excreted in urine; some hepatic metabolism may occur. Less than 1% fecal elimination.
Half-life: IV or subcut — 4 hr; Oral — 30 min.
