cytarabine

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.

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.*

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.

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.*

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.

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.*

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.

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.

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)

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.* 

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

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

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)

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)

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

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

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.

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

Seizures (with high doses)

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.