nelarabine (Rx)

Brand and Other Names:Arranon
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 5mg/mL
more...

Acute Lymphoblastic Leukemia & Lymphoma

Indicated for T-cell acute lymphoblastic leukemia & T-cell lymphoblastic lymphoma in patients after unsatisfactory treatment with at least 2 chemotherapeutic regimens

1500 mg/sq.meter IV over 2 hours on Days 1, 3, and 5; repeat q21Days 

Monitor: Neurologic status

Chronic Lymphocytic Leukemia (Orphan)

Orphan indication sponsor

  • GlaxoSmithKline LLC; Corporation Service Company, 2711 Centerville Road, Suite 400; Wilmington, DE 19808

Dosage Forms & Strengths

injectable solution

  • 5mg/mL
more...

Acute Lymphoblastic Leukemia & Lymphoma

Indicated for T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma

650 mg/sq.meter IV over 1 hour x5 consecutive days, repeat cycle q21Days 

Monitor: Neurologic status

Next:

Interactions

Interaction Checker

and nelarabine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Anemia (>50%)

            Neutropenia (>50%)

            Thrombocytopenia (>50%)

            Fatigue (in adults)

            Somnolence (in adults)

            Dizziness (in adults)

            Headache

            Peripheral neurologic disorder

            Hypoesthesia

            Paresthesia

            Asthenia (in adults)

            Pain (in adults)

            Pyrexia (in adults)

            Edema (in adults)

            Petechiae (in adults)

            Cough (in adults)

            Dyspnea (in adults)

            Pleural effusion (in adults)

            Diarrhea (in adults)

            Nausea (in adults)

            Vomiting

            Constipation (in adults)

            Leukopenia (in peds)

            Hepatobiliary d/o (in peds)

            Myalgia (in adults)

            1-10% (selected)

            Seizures (in peds)

            Ataxia (in adults)

            Insomnia (in adults)

            Anorexia (in adults)

            Decreased Ca/Mg (in peds)

            Postmarketing Reports

            Fatal opportunistic infections

            Tumor lysis syndrome

            Demyelination and ascending peripheral neuropathies (similar to Guillain-Barré syndrome)

            Previous
            Next:

            Warnings

            Black Box Warnings

            The drug should be administered under the supervision of an experienced cancer chemotherapy physician

            Administer intravenously only

            Neurologic events

            • Severe neurologic events such as altered mental states including severe somnolence, CNS effects including convulsions, and peripheral neuropathy ranging from numbness and paresthesias to motor weakness and paralysis have been reported
            • Events associated with demyelination and ascending peripheral neuropathies similar in appearance to Guillain-Barré syndrome have also been reported
            • These events are not always reversible following cessation of therapy
            • Monitor patients closely for neurologic events and discontinue therapy for neurologic events of National Cancer Institute (NCI) Common Toxicity Criteria grade 2 or greater

            Contraindications

            Hypersensitivity

            Cautions

            Risk of severe neurological problems, sometimes irreversible even on drug discontinuation

            Discontinue if CTC grade 2 or higher neurotoxicity

            Avoid pregnancy

            Give IV hydration & consider allopurinol to pts at risk for tumor lysis synd & concomitant hyperuricemia

            Do not administer live vaccines to immunocompromised patients

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Peak Plasma (adult dose): nelarabine 2-8 mcg/mL; ara-G 26-37 mcg/mL

            Half-Life, Elimination (adult dose): nelarabine 30 min; ara-G 3 hr

            Metabolism: converted to ara-G & methylguanine which are then hydrolyzed or demethylated to guanine & eventually to uric acid & allantoin

            Excretion: partially in urine

            Mechanism of Action

            Converted first to the nucleoside analog, ara-G, & subsequently to the nucleotide analog, ara-GTP, which incorporates into DNA & leads to inhibition of DNA replication & cell death

            Previous
            Next:

            Administration

            IV Administration

            Do not dilute

            Appropriate dose is transferred to infusion bags or glass containers & infused over 2 hr (adults) or 1 hr (peds)

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous