Cytarabine

IMPORTANT WARNING:

Cytarabine injection must be given under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.

Cytarbine can cause a severe decrease in the number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; black and tarry stools; red blood in stools; bloody vomit; vomited material that looks like coffee grounds.

WHY is this medicine prescribed?

Cytarabine is used alone or with other chemotherapy drugs to treat certain types of leukemia (cancer of the white blood cells), including acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), and chronic myelogenous leukemia (CML). Cytarabine is also used alone or with other chemotherapy drugs to treat meningeal leukemia (cancer in the membrane that covers and protects the spinal cord and brain). Cytarabine is in a class of medications called antimetabolites. It works by slowing or stopping the growth of cancer cells in your body.

Are there OTHER USES for this medicine?

Cytarabine is also sometimes used to treat certain types of non-Hodgkin's lymphoma (a type of cancer that begins in a type of white blood cells that normally fights infection). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Cytarabine comes as a powder to mixed with liquid to be injected intravenously (into a vein), subcutaneously (under the skin), or intrathecally (into the fluid-filled space of the spinal canal) by a doctor or nurse in a medical facility. Your doctor will tell you how often you will receive cytarabine. The schedule depends on the condition you have and on how your body responds to the medication.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving cytarabine injection,

• tell your doctor and pharmacist if you are allergic to cytarabine or any of the ingredients in cytarabine injection. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: digoxin (Lanoxin), flucytosine (Ancobon), or gentamicin. Other medications may also interact with cytarabine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

• tell your doctor if you have or have ever had kidney or liver disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not become pregnant while you are receiving cytarabine injection. If you become pregnant while receiving cytarabine, call your doctor. Cytarabine may harm the fetus.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Cytarabine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• stomach pain
• loss of appetite
• sores in the mouth and throat
• hair loss
• muscle or joint pain
• tiredness
• sore or red eyes

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• ongoing pain that begins in the stomach area but may spread to the back
• redness, pain, swelling, or burning at the site where the injection was given
• pale skin
• fainting
• dizziness
• fast or irregular heartbeat
• rash
• hives
• itching
• difficulty breathing or swallowing
• chest pain
• yellowing of the skin or eyes
• dark-colored urine or decreased urination
• shortness of breath
• sudden change or loss of vision
• seizures
• confusion
• numbness, burning, or tingling in the hands, arms, feet, or legs

Cytarabine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.