cytarabine (Rx)

Brand and Other Names:Cytosar U

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 20mg/mL
  • 100mg/mL

Acute Nonlymphocytic Leukemia

Remission induction

  • IV
    • 100-200 mg/m2/day IV continuous infusion for 5-10 days; begin second course in 2-4 weeks after initial therapy if necessary OR  
    • 100 mg/m2 IV continuous infusion for 7 days OR
    • 100 mg/m2/dose IV continuous infusion q12hr for 7 days
  • IT
    • 5-75 mg/m2 intrathecally q2-7Days until CNS findings normalize

Remission maintenance

  • 70-200 mg/m2/day IV for 2-5 days at monthly intervals

IM administration for remission maintenance

  • 1-1.5 mg/kg single dose for maintenance at 1- 4 week intervals

Meningeal Leukemia

30 mg/m2 intrathecal (IT) q4Days until CSF findings normal plus one additional dose  

Refractory Leukemia

IV administration

  • 3 g/sq.meter IV (infusion over 1-3 hours) q12hr x 4-12 doses  
  • Repeat q2-3Weeks

Dosage Forms & Strengths

injectable solution

  • 20mg/mL
  • 100mg/mL

Conventional

As in adults

Liposomal

Not recommended

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Interactions

Interaction Checker

and cytarabine

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            Contraindicated (0)

              Serious - Use Alternative (14)

              • adenovirus types 4 and 7 live, oral

                cytarabine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.

              • axicabtagene ciloleucel

                cytarabine, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • brexucabtagene autoleucel

                cytarabine, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • cedazuridine

                cedazuridine will increase the level or effect of cytarabine by decreasing metabolism. Avoid or Use Alternate Drug. Cedazuridine, a CDA inhibitor, is used with decitabine to increase systemic exposure of decitabine. Use with other drugs metabolized by CDA may increase levels and toxicities of those drugs.

              • ciltacabtagene autoleucel

                cytarabine, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • etrasimod

                etrasimod, cytarabine. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. Avoid coadministration during and in the weeks following administration of etrasimod. .

              • idecabtagene vicleucel

                cytarabine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • influenza virus vaccine quadrivalent, adjuvanted

                cytarabine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • influenza virus vaccine trivalent, adjuvanted

                cytarabine decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • lisocabtagene maraleucel

                cytarabine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • palifermin

                palifermin increases toxicity of cytarabine by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

              • ropeginterferon alfa 2b

                ropeginterferon alfa 2b, cytarabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.

              • tisagenlecleucel

                cytarabine, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • tofacitinib

                cytarabine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              Monitor Closely (20)

              • acalabrutinib

                acalabrutinib, cytarabine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

              • belatacept

                belatacept and cytarabine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

              • cholera vaccine

                cytarabine decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.

              • dengue vaccine

                cytarabine decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.

              • denosumab

                cytarabine, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

              • dichlorphenamide

                dichlorphenamide and cytarabine both decrease serum potassium. Use Caution/Monitor.

              • digoxin

                cytarabine decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Cytarabine may decrease digoxin absorption even several days after stopping chemotherapy. Digoxin capsules and digitoxin do not appear to be affected. .

              • fingolimod

                cytarabine increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .

              • hydroxyurea

                cytarabine, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.

              • influenza A (H5N1) vaccine

                cytarabine decreases effects of influenza A (H5N1) vaccine by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.

              • influenza virus vaccine (H5N1), adjuvanted

                cytarabine decreases effects of influenza virus vaccine (H5N1), adjuvanted by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.

              • meningococcal group B vaccine

                cytarabine decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.

              • ofatumumab SC

                ofatumumab SC, cytarabine. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

              • olaparib

                cytarabine and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.

              • siponimod

                siponimod and cytarabine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • sipuleucel-T

                cytarabine decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

              • tobramycin inhaled

                tobramycin inhaled and cytarabine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • trastuzumab

                trastuzumab, cytarabine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • trastuzumab deruxtecan

                trastuzumab deruxtecan, cytarabine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • ublituximab

                ublituximab and cytarabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

              Minor (5)

              • gentamicin

                cytarabine decreases effects of gentamicin by unspecified interaction mechanism. Minor/Significance Unknown.

              • maitake

                maitake increases effects of cytarabine by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).

              • taurine

                cytarabine decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.

              • vitamin A

                vitamin A, cytarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vitamin E

                vitamin E, cytarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

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              Adverse Effects

              1-10%

              Anorexia

              Nausea

              Vomiting

              Diarrhea

              Oral/anal inflammation

              Thrombophlebitis

              Bleeding

              Myelosuppression

              Rash

              Fever

              Hepatic dysfunction

              Frequency Not Defined

              Headache

              Neuropathy

              Chest pain

              Pericarditis

              Pneumonia

              Anemia

              Bleeding

              Leukopenia

              Thrombocytopenia

              Kidney disease

              Infectious disease

              Sepsis

              "Cytarabine syndrome": fever, myalgia, bone pain, rash, conjunctivitis, malaise

              Skin ulcers

              Cellulitis

              Urinary retention

              Neuritis

              Jaundice

              Anaphylaxis

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              Warnings

              Black Box Warnings

              Conventional formulation

              • Only physicians experienced in cancer chemotherapy should administer
              • Physician must judge possible benefit to patient against known toxic effects in considering advisability of therapy
              • For induction therapy, administer in facility with lab and supportive resources sufficient to monitor drug tolerance and protect and maintain patient if compromised by drug toxicity
              • Main toxic effect is bone marrow suppression with leukopenia, thrombocytopenia, and anemia
              • Less serious toxicity includes nausea, vomiting, diarrhea, abdominal pain, oral ulceration, and hepatic dysfunction

              Contraindications

              Hypersensitivity

              Cautions

              Do not use benzyl alcohol-containing solutions IT or in neonates

              This drug is a potent bone marrow suppressant; therapy should be started cautiously in patients with pre-existing drug-induced bone marrow suppression; patients receiving this drug must be under close medical supervision and, during induction therapy, should have leucocyte and platelet counts performed daily

              Bone marrow examinations should be performed frequently after blasts have disappeared from the peripheral blood; facilities should be available for management of complications, possibly fatal, of bonemarrow suppression (infection resulting from granulocytopenia and other impaired body defenses, and hemorrhage secondary to thrombocytopenia)

              Case of anaphylaxis resulting in acute cardiopulmonary arrest and required resuscitation reported; occurred immediately after intravenous administration of injection

              Severe and at times fatal CNS, GI, and pulmonary toxicity (different from that seen with conventional therapy regimens of cytarabine injection) reported following some experimental dose schedules for cytarabine injection; these reactions include reversible corneal toxicity, and hemorrhagic conjunctivitis, which may be prevented or diminished by prophylaxis with a local corticosteroid eye drop

              Cerebral and cerebellar dysfunction, including personality changes, somnolence, and coma, usually reversible; severe gastrointestinal ulceration, including pneumatosis, cystoides intestinalis leading to peritonitis; sepsis and liver abscess; pulmonary edema, liver damage with increased hyperbilirubinemia; bowel necrosis; and necrotizing colitis

              Rarely, severe skin rash, leading to desquamation reported; complete alopecia is more commonly seen with experimental high-dose therapy than with standard treatment programs using cytarabine injection

              Cases of cardiomyopathy with subsequent death reported following experimental high-dose therapy with cytarabine in combination with cyclophosphamide when used for bone marrow transplant preparation

              A syndrome of sudden respiratory distress, rapidly progressing to pulmonary edema and radiographically pronounced cardiomegaly reported following experimental high-dose therapy with cytarabine used for treatment of relapsed leukemia; the outcome of this syndrome can be fatal

              Two patients with childhood acute myelogenous leukemia who received intrathecal and intravenous cytarabine injection at conventional doses (in addition to number of other concomitantly administered drugs) developed delayed progressive ascending paralysis resulting in death in one of the two patient

              Patients receiving therapy must be monitored closely; frequent platelet and leucocyte counts and bone marrow examinations are mandatory; consider suspending or modifying therapy when drug-induced marrow depression has resulted in platelet count under 50,000 or polymorphonuclear granulocyte count under 1000/mm3

              Counts of formed elements in peripheral blood may continue to fall after drug is stopped and reach lowest values after drug-free intervals of 12 to 24 days; when indicated, restart therapy when definite signs of marrow recovery appear (on successive bone marrow studies)

              Patients whose drug is withheld until “normal” peripheral blood values are attained may escape from control; when large intravenous doses are given too quickly, patients are frequently nauseated and may vomit for several hours post-injection; this problem tends to be less severe when drug is infused

              The human liver apparently detoxifies a substantial fraction of an administered dose; in particular, patients with renal or hepatic function impairment may have higher likelihood of CNS toxicity after high-dose cytarabine injection treatment

              Use the drug with caution and possibly at reduced dose in patients whose liver or kidney function is poor; periodic checks of bone marrow, liver, and kidney functions should be performed in patients receiving cytarabine injection

              Like other cytotoxic drugs, this drug may induce hyperuricemia secondary to rapid lysis of neoplastic cells; the clinician should monitor the patient’s blood uric acid level and be prepared to use such supportive and pharmacologic measures as might be necessary to control this problem

              Acute pancreatitis reported to occur in a patient receiving injection by continuous infusion and in patients being treated who have had prior treatment with L-asparaginase

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              Pregnancy & Lactation

              Pregnancy

              Therapy can cause fetal harm when administered to a pregnant woman

              There are no adequate and well-controlled studies in pregnant women

              Women of childbearing potential should be advised to avoid becoming pregnant; a review of the literature has shown 32 reported cases where cytarabine injection was given during pregnancy, either alone or in combination with other cytotoxic agents; eighteen normal infants were delivered; four of these had first-trimester exposure; five infants were premature or of low birth weight; twelve of the 18 normal infants were followed up at ages ranging from six weeks to seven years, and showed no abnormalities; one apparently normal infant died at 90 days of gastroenteritis

              Two cases of congenital abnormalities reported, one with upper and lower distal limb defects, and the other with extremity and ear deformities; both of these cases had first-trimester exposure

              There were seven infants with various problems in the neonatal period, including pancytopenia, transient depression of WBC, hematocrit or platelets; electrolyte abnormalities; transient eosinophilia; and one case of increased lgM levels and hyperpyrexia possibly due to sepsis; six of the seven infants were also premature

              The child with pancytopenia died at 21 days of sepsis; therapeutic abortions were done in five cases; four fetuses were grossly normal, but one had an enlarged spleen and another showed Trisomy C chromosome abnormality in chorionic tissue

              Because of potential for abnormalities with cytotoxic therapy, particularly during first trimester, a patient who is or who may become pregnant while on therapy should be apprised of potential risk to fetus and advisability of pregnancy continuation

              There is a definite, but considerably reduced risk if therapy is initiated during second or third trimester; although normal infants delivered to patients treated in all three trimesters of pregnancy, follow-up of such infants would be advisable

              Animal data

              • Cytarabine causes abnormal cerebellar development in neonatal hamster and is teratogenic to rat fetus

              Lactation

              Not known whether this drug is excreted in human milk; because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing infants from this drug, a decision should be made whether to discontinue nursing or to discontinue drug,taking into account importance of drug to the mother

              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.

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              Pharmacology

              Mechanism of Action

              Metabolite cytarabine-5'-triphosphate inhibits DNA polymerase during S phase

              Absorption

              Systemic Exposure after IT: negligible

              Peak plasma time: 20-60 min

              Peak CSF time (IT): 60 min

              Peak CSF concentration (IT): 30-50 mcg/mL

              Distribution

              Protein bound: 13%

              Metabolism

              Metabolism: liver (major), kidneys (minor); neglible following IT administration

              Metabolites: cytarabine-5'-triphosphate (ara-CTP)

              Elimination

              Half-life: 1-3 hr

              Half-life (CSF after IT): 5.9-82.4 hr

              CSF clearance rate: 0.24 mL/min

              Excretion: urine

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              Administration

              IV Incompatibilities

              Additive: fluorouracil, gentamicin, heparin, hydrocortisone sodium succinate, insulin, methylprednisolone, nafcillin, oxacillin, penicillin G sodium

              Y-site: allopurinol, amphotericin B cholesteryl SO4, ganciclovir

              IV Compatibilities

              Solution: compatible with most common IV fluids

              Additive: corticotropin, daunorubicin/etoposide, hydroxyzine, lincomycin, methotrexate, mitoxantrone, ondansetron, KCl, NaHCO3, vincristine

              Syringe: metoclopramide

              Y-site: amifostine, amsacrine, aztreonam, cefepime, chlorpromazine, cimetidine, cladribine, dexamethasone, diphenhydramine, doxorubicin liposomal, droperidol, etoposide PO4, famotidine, filgrastim, fludarabine, furosemide, gatifloxacin, gemcitabine, gentamicin, granisetron, heparin, hydrocortisone, hydromorphone, idarubicin, linezolid, lorazepam, melphalan, methotrexate, methylprednisolone, metoclopramide, morphine SO4, ondansetron, paclitaxel, piperacillin/tazobactam, prochlorperazine, promethazine, propofol, ranitidine, sargramostim, Na Bicarb, teniposide, thiotepa, vinorelbine

              IV Administration

              Rapid IV, infusion over 1-3 hr

              Has been administered by IM & continuous SC infusion

              Storage

              Store intact vials at controlled room temp

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              cytarabine injection
              -
              20 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              cytarabine injection

              CYTARABINE - INJECTION

              (sye-TAIR-uh-bean)

              COMMON BRAND NAME(S): Cytosar-U, Tarabine PFS

              WARNING: This medication decreases bone marrow function, an effect that may lead to a low number of blood cells such as red cells, white cells, and platelets. This effect can cause anemia, decrease your body's ability to fight an infection, or cause easy bruising/bleeding. Tell your doctor right away if you develop any of the following symptoms: unusual tiredness, pale skin, signs of infection (such as sore throat that doesn't go away, fever, chills), easy bruising/bleeding.

              USES: Cytarabine is used to treat various types of cancer. It is a chemotherapy drug that works by slowing or stopping cancer cell growth.

              HOW TO USE: This medication is usually given by injection into a vein by a health care professional. It may also be given by other methods of injection depending upon your medical condition. The dosage is based on your medical condition, body size, and response to treatment.Unless your doctor instructs you otherwise, drink plenty of fluids while using this medication. This helps your kidneys remove the drug from your body and may help you avoid some of the side effects.

              SIDE EFFECTS: See also Warning section.Nausea, vomiting, loss of appetite, diarrhea, headache, dizziness, mouth sores, and pain/swelling/redness at the injection site may occur. Nausea and vomiting can be severe. In some cases, drug therapy may be needed to prevent or relieve nausea and vomiting. Not eating before your treatment may help relieve vomiting. Changes in diet such as eating several small meals or limiting activity may help lessen some of these effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: signs of liver problems (such as nausea/vomiting that doesn't stop, stomach/abdominal pain, dark urine, yellowing eyes/skin), muscle/bone pain, chest pain, shortness of breath, eye redness/itching/pain, vision problems (including blindness), painful/difficult swallowing, anal sores, signs of kidney problems (such as change in the amount of urine), painful/difficult urination, joint/side/back pain, numbness or tingling of hands/feet, freckling, big toe pain, black/bloody stools, vomit that looks like coffee grounds, mental/mood changes (such as confusion, unusual drowsiness), enlarged abdomen, muscle weakness, loss of coordination, inability to move (paralysis), seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using cytarabine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: decreased bone marrow function/blood cell disorders (such as anemia, leukopenia, thrombocytopenia), liver disease, kidney disease, gout.Cytarabine can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.Tell your health care professional that you are using cytarabine before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using cytarabine. Cytarabine may harm an unborn baby, especially in the first 3 months of pregnancy. Ask about reliable forms of birth control while using this medication. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this drug. Consult your doctor before breastfeeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: digoxin, flucytosine, gentamicin.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include confusion, mental/mood changes.

              NOTES: Lab and/or medical tests (such as complete blood counts, liver/kidney function, uric acid levels) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

              STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised October 2023. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              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.
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              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
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              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.