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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

cytarabine

( sye-TAR-a-been )
Other Name(s): Cytosar® (multiple brands available)
Appearance: Clear solution ; may be mixed into larger bags of fluids

Medication Information Sheet
cytarabine (sye-TAR-a-been)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Generic brand(s) available, Cytosar®

Appearance:
Clear solution

; may be mixed into larger bags of fluids

What is this medication for?
  •  For treating blood cancers such as leukemia and lymphoma.

What should I do before I have this medication?
  • Tell  your doctor if you have/had significant medical condition(s), especially if you have / had heart, liver, lung, nerve or eye problems, or if you have any allergies.
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:► Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while on cytarabine treatment.
  • Effects on Fertility: Probable
How is this medication given?
  • This drug is given by injection into a vein.

 

 

 

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

What are the side effects of this medication?

Common side effects usually occur in more than 1 out of every 10 patients. Other side effects are less common, but may be severe. You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
More Common Side Effects

Abnormal liver lab tests (may be severe)

  • Your doctor will monitor these regularly.  Call your doctor if you have yellowish skin or eyes, or unusually dark urine.

 

Contact your health care team if no improvement or if severe

Hair thinning or loss (more common with high doses)

  • Use a gentle soft brush; care should be taken with hair sprays, bleaches, dyes and perms.
  • Your hair usually grows back after your treatment ends, but the texture or colour may be different.

Diarrhea

  • May occur days to weeks after the drug is given / after treatment starts.
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine (coffee, tea or cola), orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
  • Also see Diarrhea pamphlet.*
Contact your health care team if no improvement or if severe

Flu-like feeling
(fever, chills, muscle pain, without signs of infection such as sore throat, cough, or blistering rash on skin)

  • May happen in hours to days after drug is given / after starting treatment.
  • These side effects may go away as your body gets used to the drug.
  • Contact your doctor or nurse if these feelings bother you.
  • May take acetaminophen (Tylenol®) tablets as needed.
Contact your health care team if no improvement or if severe

Mouth sores

  • Maintain good mouth hygiene. Regular teeth brushing with a soft toothbrush or Toothette®, and regular use of alcohol-free mouthwashes.
  • Instead, try a homemade mouthwash: 
  • Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
  • Avoid hot, spicy, acidic, hard or crunchy foods.
  • Check with your doctor or nurse as soon as you notice sores in mouth/lips or pain with swallowing. Your doctor may prescribe a prescription mouthwash to relieve mouth sores and prevent infection.
  • Also see Mouth Care pamphlet.*
Contact your health care team as soon as possible

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Nausea and vomiting

  • May occur in hours to days after the dose is given/ after treatment starts.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Also see Nausea & Vomiting pamphlet.*
Contact your health care team if no improvement or if severe

Rash; dry, itchy skin

  • May be severe, including blisters or skin peeling; get emergency medical help right away if this occurs.
  • Stay out of the sun; wear sunblock, a hat and cover exposed skin.
  • Use daily moisturizer.
Contact your health care team if no improvement or if severe

Poor Appetite; don't feel like eating; weight loss

  • Eat foods that you like and try to eat regular small meals.
  • Use meal supplements if possible.  See a dietitian.

 

Contact your health care team if no improvement or if severe

Eye problems (more common with high doses)
(dry eyes, redness, irritation, pain, tearing, sensitivity to light, blurred vision or other unusual changes with your sight)

Contact your health care team as soon as possible

Hand-foot syndrome   (pain, thinning or reddening palms or feet, including tingling, numbness, peeling)      

  • May occur in days to weeks after the dose is given/ after starting treatment.     
  • Avoid activities that cause rubbing, pressure or heat exposure to hands and feet (i.e. gripping tools, vigorous washing, hot baths).     
  • Apply moisturizer liberally and often to your hands and feet, especially in the folds of the skin.     
  • Wear loose, comfortable footwear and clothes. 
  • Rest and try to keep off your feet.     
  • Also see Hand-Foot Syndrome pamphlet.* 
Contact your health care team if no improvement or if severe

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Lung problems
(increased cough, breathing problems, chest pain, coughing blood)

Get emergency medical help right away

Infection of the intestines (abdominal pain, nausea, vomiting, diarrhea, fever)

Get emergency medical help right away

Allergic reaction (fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness; may occur during or shortly after the drug is given)

Get emergency medical help right away
Hole in stomach or intestine wall  (sudden, severe pain in belly or stomach area) Get emergency medical help right away

Effects on the brain (confusion, difficulty with thinking, speaking, movement or balance, blurred and/or loss of vision, weakness on one side of the body)

 

Get emergency medical help right away

Pancreas problems
(increased pain in centre of belly and may extend to the back, appetite or weight loss)

Get emergency medical help right away

Heart problems
(irregular heartbeat, chest pain, fainting, swelling in legs/ankles/belly, shortness of breath)

 

Get emergency medical help right away

Tingling, numb fingers and toes

  • Contact your doctor or nurse if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble with movement.
  • May slowly return to normal after treatment ends.
Contact your health care team as soon as possible

Kidney problems
(lower back pain, body swelling, passing little or no urine, or recent unusual weight gain)

Get emergency medical help right away

Seizures (with high doses)

Get emergency medical help right away

Rapid killing of cancer cells when you start treatment may lead to build up of cell waste products

  • If mild, this may cause gout, with joint pains, but if severe, may cause fevers, kidney failure, confusion and be life-threatening.
  • You MUST take the preventive medicines given by your doctor AND
  • Drink plenty of fluids (6-8 glasses per day) and void (urinate) frequently.
Get emergency medical help right away

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.