Home Drugs by Condition M Meningitis, Lymphomatous DepoCyt Side Effects

DepoCyt Side Effects

Generic Name: cytarabine liposomal

Please note - some side effects for DepoCyt may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of DepoCyt - for the Consumer

DepoCyt

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 when using DepoCyt:

Change in appetite; constipation; cough; diarrhea; dizziness; drowsiness; mouth or tongue sores; stomach pain; tiredness; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain; bowel or bladder problems; burning, pain, numbness, or tingling; confusion; decreased sense of touch; difficult or painful urination; difficulty walking; fast or irregular heartbeat; fainting; fever, chills, or persistent sore throat; headache; hearing problems (eg, hearing loss); joint pain; memory problems; mental or mood changes (eg, agitation, anxiety, depression); muscle pain, weakness, or cramping; nausea; neck pain or rigidity; one-sided weakness; pain, redness, or swelling at the injection site; seizures; severe or persistent dizziness, drowsiness, or light-headedness; severe or persistent dry mouth or eyes; shortness of breath; sluggishness; swelling of the hands, ankles, or feet; tremor; trouble sleeping; trouble swallowing; unusual bruising or bleeding; unusual tiredness or weakness; vision problems (eg, blurred vision, vision loss); vomiting.

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.

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DepoCyt Side Effects - for the Professional

DepoCyt

The toxicity database consists of the observations made during Phase 1-4 studies. The most common adverse reactions in all patients and in patients with lymphoma are shown in Table 2 below.

Arachnoiditis is an expected and well-documented side effect of both neoplastic meningitis and of intrathecal chemotherapy. The incidence of severe and life-threatening arachnoiditis in patients receiving DepoCyt was 19% (48/257) in all patients and 30% (10/33) in patients with lymphomatous meningitis. The incidence of symptoms possibly reflecting meningeal irritation are shown in Table 3.

In the early dose-finding study, chemical arachnoiditis was observed in 100% of cycles without dexamethasone prophylaxis. When concurrent dexamethasone was administered, chemical arachnoiditis was observed in 33% of cycles. Patients receiving DepoCyt should be treated concurrently with dexamethasone to mitigate the symptoms of chemical arachnoiditis.

Table 2. Incidence of adverse reactions occurring in > 10% of patients in all Phase 1-4 adult study patients and in patients with lymphomatous meningitis receiving DepoCyt 50 mg or an active comparator
     Lymphoma
System Organ Class /
Preferred Term
All DepoCyt
(N=257)
DepoCyt
(N=33)
Ara-C
(N=28)
Nervous System Disorders
  Headache NOS 144 (56%) 17 (52%) 9 (32%)
  Arachnoiditis 108 (42%) 14 (42%) 10 (36%)
  Confusion 86 (33%) 12 (36%) 3 (11%)
  Gait Abnormal NOS 60 (23%) 7 (21%) 8 (29%)
  Convulsions NOS 52 (20%) 7 (21%) 1 (4%)
  Dizziness NOS 47 (18%) 7 (21%) 6 (21%)
  Memory Impairment 36 (14%) 4 (12%) 1 (4%)
  Hypoaesthesia 26 (10%) 4 (12%) 3 (11%)
  Tremor 22 (9%) 5 (15%) 5 (18%)
  Peripheral Neuropathy NOS 9 (4%) 4 (12%) 1 (4%)
  Syncope 8 (3%) 0 (0%) 3 (11%)
  Neuropathy NOS 7 (3%) 3 (9%) 3 (11%)
  Peripheral Sensory Neuropathy 7 (3%) 2 (6%) 3 (11%)
  Reflexes Abnormal 7 (3%) 0 (0%) 3 (11%)
General Disorders and Administration
Site Conditions
  Weakness 103 (40%) 13 (39%) 15 (54%)
  Pyrexia 81 (32%) 15 (45%) 12 (43%)
  Fatigue 64 (25%) 9 (27%) 13 (46%)
  Lethargy 41 (16%) 4 (12%) 4 (14%)
  Death NOS 35 (14%) 9 (27%) 5 (18%)
  Pain NOS 35 (14%) 3 (9%) 5 (18%)
  Oedema Peripheral 27 (11%) 6 (18%) 7 (25%)
  Fall 12 (5%) 0 (0%) 3 (11%)
  Mucosal Inflammation NOS 8 (3%) 4 (12%) 2 (7%)
  Oedema NOS 6 (2%) 1 (3%) 6 (21%)
Gastrointestinal Disorders
  Nausea 117 (46%) 11 (33%) 15 (54%)
  Vomiting NOS 112 (44%) 11 (33%) 9 (32%)
  Constipation 64 (25%) 8 (24%) 7 (25%)
  Diarrhoea NOS 31 (12%) 9 (27%) 9 (32%)
  Abdominal Pain NOS 22 (9%) 5 (15%) 4 (14%)
  Dysphagia 20 (8%) 3 (9%) 3 (11%)
  Haemorrhoids 8 (3%) 0 (0%) 3 (11%)
Musculoskeletal and Connective Tissue
Disorders
  Back Pain 61 (24%) 7 (21%) 5 (18%)
  Pain in Limb 39 (15%) 4 (12%) 8 (29%)
  Neck Pain 36 (14%) 5 (15%) 3 (11%)
  Arthralgia 29 (11%) 3 (9%) 4 (14%)
  Neck Stiffness 28 (11%) 2 (6%) 4 (14%)
  Muscle Weakness NOS 25 (10%) 5 (15%) 2 (7%)
Psychiatric Disorders
  Insomnia 35 (14%) 6 (18%) 7 (25%)
  Agitation 26 (10%) 5 (15%) 2 (7%)
  Depression 21 (8%) 6 (18%) 4 (14%)
  Anxiety 17 (7%) 1 (3%) 3 (11%)
Infections and Infestations
  Urinary Tract Infection NOS 35 (14%) 6 (18%) 5 (18%)
  Pneumonia NOS 16 (6%) 2 (6%) 3 (11%)
Metabolism and Nutrition Disorders
  Dehydration 33 (13%) 6 (18%) 3 (11%)
  Appetite Decreased NOS 29 (11%) 4 (12%) 3 (11%)
  Hyponatraemia 18 (7%) 4 (12%) 1 (4%)
  Hypokalaemia 17 (7%) 5 (15%) 2 (7%)
  Hyperglycaemia 15 (6%) 4 (12%) 2 (7%)
  Anorexia 14 (5%) 1 (3%) 5 (18%)
Investigations
  Platelet Count Decreased 8 (3%) 0 (0%) 3 (11%)
Renal and Urinary Disorders
  Incontinence NOS 19 (7%) 3 (9%) 5 (18%)
  Urinary Retention 14 (5%) 0 (0%) 3 (11%)
Respiratory, Thoracic and Mediastinal
Disorders
  Dyspnoea NOS 25 (10%) 4 (12%) 6 (21%)
  Cough 17 (7%) 3 (9%) 6 (21%)
Eye Disorders
  Vision Blurred 29 (11%) 4 (12%) 4 (14%)
Blood and Lymphatic Disorders
  Anaemia NOS 31 (12%) 6 (18%) 5 (18%)
  Thrombocytopenia 27 (11%) 8 (24%) 9 (32%)
  Neutropenia 26 (10%) 12 (36%) 7 (25%)
Skin and Subcutaneous Tissue
Disorders
  Contusion 6 (2%) 1 (3%) 3 (11%)
  Pruritus NOS 6 (2%) 0 (0%) 4 (14%)
  Sweating Increased 6 (2%) 1 (3%) 3 (11%)
Vascular Disorders
  Hypotension NOS 21 (8%) 6 (18%) 2 (7%)
  Hypertension NOS 15 (6%) 5 (15%) 1 (4%)
Ear and Labyrinth Disorders
  Hypoacusis 15 (6%) 6 (18%) 3 (11%)
Cardiac Disorders
  Tachycardia NOS 22 (9%) 0 (0%) 5 (18%)
Neoplasms Benign, Malignant and
Unspecified (Incl Cysts and Polyps)
  Diffuse Large B-Cell Lymphoma NOS 1 (0%) 1 (3%) 3 (11%)

Table 3. Incidence of adverse reactions possibly reflecting meningeal irritation occurring in > 10% of all studied adult patients receiving DepoCyt 50 mg or an active comparator*

* Hydrocephalus acquired, CSF pleocytosis and meningism occurred in ≤ 10% of all studied adult patients receiving DepoCyt or an active comparator

System Organ Class /
Preferred Term
DepoCyt
(N=257)
MTX
(N=78)
Ara-C
(N=28)
Nervous System Disorders
  Headache NOS 145 (56%) 33 (42%) 9 (32%)
  Arachnoiditis 108 (42%) 15 (19%) 10 (36%)
  Convulsions NOS 56 (22%) 11 (14%) 1 (4%)
Gastrointestinal Disorders
  Nausea 117 (46%) 24 (31%) 15 (54%)
  Vomiting NOS 112 (44%) 22 (28%) 9 (32%)
Musculoskeltal and Connective Tissue
Disorders
  Back Pain 61 (24%) 15 (19%) 5 (18%)
  Neck Pain 36 (14%) 6 (8%) 3 (11%)
  Neck Stiffness 28 (11%) 1 (1%) 4 (14%)
General Disorders and Administration
Site Conditions
  Pyrexia 81 (32%) 15 (19%) 12 (43%)
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Side Effects by Body System - for Healthcare Professionals

Nervous system

Nervous system side effects including headache (56%), arachnoiditis (42%) confusion (up to 33%) abnormal gait (up to 23%), convulsions (20%), dizziness (18%), memory impairment (14%), somnolence (12%), hypoesthesia (10%), tremor (9%), peripheral neuropathy (4%), syncope (3%), neuropathy (3%), peripheral sensory neuropathy (3%), and abnormal reflexes (3%) have been reported. Hydrocephalus, hemiplegia, visual disturbances (including blindness), deafness, and cranial nerve palsies, numbness, paresthesia, weakness, and impaired bowel and bladder control have also been reported.

Chemical arachnoiditis is a syndrome which is a common adverse event associated with the use of cytarabine liposomal. This syndrome includes headache, fever, and back pain. The incidence and severity of chemical arachnoiditis may be reduced by coadministration with dexamethasone.

Hydrocephalus may have been precipitated by arachnoiditis.

Infectious meningitis may be associated with intrathecal drug administration.

Gastrointestinal

Gastrointestinal side effects including nausea (46%), vomiting (up to 44%), constipation (25%), diarrhea (12%), nausea (11%), abdominal pain (9%), dysphagia (8%), constipation (7%), and hemorrhoids (3%) have been reported.

Other

Other side effects including weakness (40%), pyrexia (up to 32%), fatigue (25%), asthenia (19%), lethargy (16%), death (14%), pain (up to 14%), peripheral edema (11%), back pain (7%), hypoacusis (6%), fall (5%), mucosal inflammation (3%), and edema (2%) have been reported.

Musculoskeletal

Musculoskeletal side effects including back pain (24%), pain in limb (15%), neck pain (14%), arthralgia (11%), neck stiffness (11%), and muscle weakness (10%) have been reported.

Psychiatric

Psychiatric side effects including insomnia (14%), agitation (10%), depression (8%), and anxiety (7%) have been reported.

Renal

Renal side effects including urinary tract infection (14%) have been reported.

Metabolic

Metabolic side effects including dehydration (13%), decreased appetite (11%), hyponatremia (7%), peripheral edema (7%), hypokalemia (7%), hyperglycemia (6%), and anorexia (5%) have been reported.

Hematologic

Hematologic side effects including anemia (12%), thrombocytopenia (up to 11%), and neutropenia (up to 10%) have been reported.

Ocular

Ocular side effects including blurred vision (11%) have been reported.

Respiratory

Respiratory side effects including dyspnea (10%), cough (7%), and pneumonia (6%) have been reported.

Cardiovascular

Cardiovascular side effects including tachycardia (9%), hypotension (8%), and hypertension (6%) have been reported.

Genitourinary

Genitourinary side effects including urinary incontinence (7%) and urinary retention (5%) have been reported.

Dermatologic

Dermatologic side effects including contusion (2%), pruritus (2%), and increased sweating (2%) have been reported.

Oncologic

Oncologic side effects including a case of diffuse large B-cell lymphoma have been reported.

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