Cytarabine liposomal/daunorubicin liposomal Disease Interactions

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

The use of cytarabine liposomal is contraindicated in patients with active meningeal infection.

Cytarabine is a potent bone marrow suppressant. Therapy with cytarabine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. 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. Consider suspending or modifying therapy when drug-induced marrow depression has resulted in a platelet count under 50,000 or a polymorphonuclear granulocyte count under 1000/mm3.

Daunorubicin can cause myocardial toxicity leading to congestive heart failure. Patients with preexisting heart disease or prior anthracycline therapy are at increased risk of congestive heart failure. The benefit-to-risk ratio of daunorubicin therapy in such patients should be weighed before starting treatment. The incidence of drug-induced congestive heart failure in adults is increased when the total cumulative dose of daunorubicin exceeds 550/mg/m2. An electrocardiogram and/or determination of systolic ejection fraction prior to each course of therapy is recommended.

Daunorubicin can induce severe myelosuppression at therapeutic doses. The use of daunorubicin may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with daunorubicin. Close clinical monitoring of hematopoietic function is recommended.

Daunorubicin hydrochloride is a potent bone marrow suppressant. Suppression will occur in all patients given a therapeutic dose of this drug. Therapy with daunorubicin hydrochloride should not be started in patients with preexisting-existing drug-induced bone marrow suppression unless the benefit from such treatment warrants the risk. Persistent, severe myelosuppression may result in superinfection or hemorrhage.