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Cytarabine is a chemotherapy drug| given to treat acute myeloid leukaemia| (AML). It may also be used to treat some other types of leukaemia and lymphomas. It is sometimes called Ara C or cytosine arabinoside.
Cytarabine is a colourless fluid.
Cytarabine may be given in one of the following ways:
The infusion may sometimes be given over several days.
Cytarabine can also be given:
Only certain specially-trained staff are able to give intrathecal cytarabine, so it may be given in a different part of your hospital and by different staff from the rest of your chemotherapy. In some situations, you may have to travel to a different hospital to have intrathecal cytarabine.
Chemotherapy| is usually given as a course of several sessions (or cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer you're being treated for. Your nurse or doctor will discuss your treatment plan with you.
Before you begin your treatment your doctor will arrange for you to have blood tests. You'll usually be given anti-sickness drugs before and/or during your treatment.
Each person’s reaction to chemotherapy is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone who is given cytarabine and may be different if you're having more than one type of chemotherapy drug|.
We have outlined the most common side effects but haven't included those that are rare and unlikely to affect you. If you notice any effects that are not listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
Cytarabine can reduce the number of white blood cells, which help fight infection. White cells are produced by the bone marrow. If the number of your white blood cells is low you'll be more prone to infections|. A low white blood cell count is called neutropenia.
Neutropenia begins seven days after treatment, and your resistance to infection is usually at its lowest 10–14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.
You'll have regular blood tests to check the numbers of white blood cells in your blood. Occasionally, your treatment may need to be delayed if the number of your blood cells (blood count) is still low.
Cytarabine can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You may need to have a platelet transfusion| if your platelet count is low.
Cytabarine can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired| and breathless|. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion| if the number of red blood cells becomes too low.
This may begin soon after the treatment is given. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting|. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.
Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
Cytarabine can cause diarrhoea|. This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
Some people lose their appetite| because of chemotherapy treament. This can be mild and may only last a few days. If it doesn’t improve you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight|.
This can result in a condition called gout, which causes inflammation of the joints. To prevent this, you may be given a drug called allopurinol (Zyloric®), and you may be asked to drink plenty of fluids. While you are having cytarabine you may have regular blood tests to check your uric acid levels.
Cytarabine may cause an inflammation of the lining of the eyelids (conjunctiva) that makes your eyes feel sore, red and itchy (conjunctivitis). Let your doctor know so they can prescribe soothing eye drops if necessary.
Your mouth may become sore| or dry, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help reduce the risk of this happening. Some people may find sucking on ice soothing. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections.
You may notice that food tastes different|. Normal taste usually comes back after treatment finishes. A dietitian or specialist nurse at your hospital can give you advice about ways of coping with this side effect.
This is rare, but your hair may thin or occasionally fall out completely. If this happens, it usually begins about 3–4 weeks after starting treatment, although it may occur earlier. This is temporary and your hair will start to grow back once the treatment has finished. Your hair may grow back straighter, curlier, finer, or a slightly different colour than it was before. Your nurse can give you advice about coping with hair loss|.
Treatment with cytarabine may cause changes in the way your liver| works, although it will return to normal when the treatment finishes. You're very unlikely to notice any problems, but your doctor will take regular blood samples to check your liver is working properly.
Feeling tired is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
The chemotherapy may cause some changes to the lungs|. Tell your doctor if you smoke or if you notice any coughing or breathlessness.
A skin rash can sometimes occur while you are having treatment with cytarabine. It’s important to let your doctor know if this happens. Your doctor can prescribe medicine to help with this.
Cytarabine can also cause soreness and redness of the palms of the hands and soles of the feet (hand-foot syndrome). This is temporary and usually improves once treatment finishes.
You may develop flu-like symptoms a few hours after the treatment has been given. These include headaches, aching joints or muscles, high temperature (fever), lack of energy (lethargy) and chills. If this happens, it's important to drink plenty of fluids and get some rest. If these symptoms continue for more than a day contact your doctor.
Standard doses of cytarabine rarely have any effect on the nervous system. But, high-dose treatment with cytarabine can cause temporary or occasionally permanent changes to the nervous system. This may cause a variety of symptoms, including seizures (fits), drowsiness, unsteadiness and mood changes. Tell your doctor right away if you have any of these symptoms: lack of energy (lethargy), sleepiness, confusion and loss of balance
Cytabarine can cause pain at the place where the injection is given or along the vein. If you feel pain, tell your nurse or doctor straight away so that they can check the site. They may give the drug more slowly or flush it through with more fluid to reduce pain.
If cytarabine is given by lumbar puncture (intrathecally), the side effects may be different from those mentioned here. Your doctor or nurse can discuss this with you.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Cancer can increase the risk of developing a blood clot (thrombosis), and chemotherapy may increase this risk further.
A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it’s important to tell your doctor straight away if you notice any of these symptoms. Most clots can be treated with drugs that thin the blood. The doctor or nurse can give you more information.
Your ability to become pregnant or father a child may be affected by having this treatment. It's important to discuss fertility| with your doctor before starting treatment.
It's not advisable to become pregnant or father a child while having cytarabine as it may harm the developing baby. It’s important to use effective contraception while having this drug and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner, it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after chemotherapy.
There is a potential risk that chemotherapy drugs may be present in breast milk. Women are advised not to breastfeed during chemotherapy and for a few months afterwards.
Some other medicines, including those you can buy in a shop or chemist, can be harmful to take when you're having chemotherapy. Tell your doctor about any medicines you're taking, including over-the-counter drugs, complementary therapies| and herbal drugs|.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you're having chemotherapy treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. During office hours you can contact the clinic or ward where you had your treatment. Your chemotherapy nurse or doctor will tell you who to contact during the evening or at weekends.
This section is based on our Cytarabine factsheet which has been compiled using information from a number of reliable sources, including:
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