Clofarabine

Generic Name: clofarabine (kloe-FAR-a-been)
Brand Name: Clolar

Clofarabine is used for:

Treating a type of leukemia in certain patients who have had at least 2 previous treatment regimens of medicine.

Clofarabine is a form of antimetabolite chemotherapy. It works by blocking cancer cell growth, which results in death of the cancer cell.

Do NOT use clofarabine if:

  • you are allergic to any ingredient in clofarabine
  • you are taking medicines that may affect the kidney, such as aminoglycoside antibiotics (eg, gentamicin), amphotericin B, cyclosporine, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), tacrolimus, and vancomycin. Ask your doctor if you are unsure whether any of your medicines might affect your kidneys
  • you are taking medicines that may affect the liver (such as acetaminophen), certain medicines for HIV infection, isoniazid, ketoconazole, and methotrexate. Ask your doctor if you are unsure whether any of your medicines might affect your liver

Contact your doctor or health care provider right away if any of these apply to you.

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Before using clofarabine:

Some medical conditions may interact with clofarabine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have high or low blood pressure, kidney problems, liver problems, or heart problems
  • if you have an infection, certain blood problems (eg, low white blood cell levels, low platelet levels), or bone marrow problems
  • if you have previously had a hematopoietic stem cell transplant (HSCT)

Some MEDICINES MAY INTERACT with clofarabine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Medicines that may affect your heart function or blood pressure because the side effects of clofarabine, such as low blood pressure or heart effects, may be increased. Ask your doctor if you are unsure whether any of your medicines might affect your heart function or blood pressure
  • Medicines that affect your kidneys or liver because the risk of clofarabine's side effects may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if clofarabine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use clofarabine:

Use clofarabine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Clofarabine is given as an injection at your doctor's office, hospital, or clinic. Contact your health care provider if you have any questions.
  • If you miss a dose of clofarabine, contact your doctor to find out what to do.

Ask your health care provider any questions you may have about how to use clofarabine.

Important safety information:

  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • Notify your doctor immediately if you experience symptoms of dehydration such as dry mouth; decreased urination; unusual thirst; weakness; unusual drowsiness or lethargy; muscle pain, cramps, or weakness; severe dizziness or fainting; or rapid heartbeat.
  • Clofarabine may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Clofarabine may lower the ability of your body to fight infection. Severe and sometimes fatal infections have happened with clofarabine. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection such as fever, sore throat, rash, or chills.
  • Serious and sometimes fatal bleeding (eg, bleeding in the brain, stomach or bowels, or lungs) has happened with clofarabine. Most of the time, this happened in people with low blood platelet levels. Discuss any questions or concerns with your doctor.
  • Serious and sometimes fatal bowel problems have happened with clofarabine. Most of the time, this happened within 30 days of treatment and when more than 1 chemo medicine was used. Discuss any questions or concerns with your doctor.
  • Very bad skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis) have happened with clofarabine. They can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
  • Liver problems have happened with clofarabine. Sometimes, this has been fatal. Call your doctor right away if you have symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, severe or unusual stomach pain, yellowing of the skin or eyes).
  • A serious and possibly fatal condition called tumor lysis syndrome has been rarely reported in certain patients taking clofarabine. Contact your doctor right away if you develop symptoms such as fast or irregular heartbeat; fainting; decreased urination; muscle weakness or cramps; nausea, vomiting, diarrhea, or loss of appetite; or sluggishness. Discuss any questions or concerns with your doctor.
  • Clofarabine may cause the release of proteins called cytokines. This may lead to some other health problems and organ problems. Sometimes, these may be deadly. Call your doctor right away if you have a fever, fast heartbeat, fast breathing, shortness of breath, severe dizziness, or fainting.
  • Proper dental care is important while you are taking clofarabine. Brush and floss your teeth and visit the dentist regularly.
  • Do not receive a live vaccine (eg, measles, mumps) while you are taking clofarabine. Talk with your doctor before you receive any vaccine.
  • Tell your doctor or dentist that you take clofarabine before you receive any medical or dental care, emergency care, or surgery.
  • Women who may become pregnant must use an effective form of birth control while they take clofarabine. If you have questions about effective birth control, talk with your doctor.
  • Men who use clofarabine should always use a condom when having sex with a woman who may become pregnant. Do this for as long as you use clofarabine.
  • Lab tests including blood counts, blood pressure, lung function, liver function, kidney function, and blood uric acid levels may be performed while you use clofarabine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Safety and effectiveness of clofarabine have not been established in ADULTS older than 21 years of age.
  • PREGNANCY AND BREAST-FEEDING: Clofarabine may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using clofarabine while you are pregnant. It is not known if clofarabine is found in breast milk. Do not breast-feed while taking clofarabine.

Possible side effects of clofarabine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; back pain; diarrhea; drowsiness; flushing; headache; joint or muscle pain or weakness; loss of appetite; mild stomach pain; mild tiredness or weakness; minor pain, swelling, or redness at the injection site; nausea; swelling or soreness of the mouth; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, red, or tarry stools; bleeding from the gums; blistering or severe swelling or pain at the injection site; chest pain; confusion; coughing up blood; fainting; fast breathing; fast or irregular heartbeat; fever, chills, or sore throat; mental or mood changes; nosebleed; one-sided weakness; persistent cough; severe or persistent dizziness, light-headedness, or headache; severe or persistent nausea, vomiting, stomach pain, or diarrhea; severe or persistent tiredness or weakness; shortness of breath; small red spots under the skin; speech or vision problems; swelling of arms or legs; symptoms of kidney problems (eg, big weight gain, blood in the urine, cloudy urine, decreased urination); tingling, pain, redness, or swelling of the palms of the hands or soles of the feet; unusual bleeding or easy bruising; unusually pale skin; vomiting blood or vomit that looks like coffee grounds; white patches in the mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of clofarabine:

Clofarabine is handled and stored by a health care provider. You will not store it at home. Keep all medicines out of the reach of children and away from pets.

General information:

  • If you have any questions about clofarabine, please talk with your doctor, pharmacist, or other health care provider.
  • Clofarabine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take clofarabine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about clofarabine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to clofarabine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using clofarabine.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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