Cytarabine Liposomal Dosage
Applies to the following strength(s): 10 mg/mL
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Meningitis - Lymphomatous
Cytarabine liposomal for the intrathecal treatment of lymphomatous meningitis:
Induction Therapy: cytarabine liposome injection 50 mg, administered intrathecally (intraventricular or lumbar puncture) every 14 days for 2 doses (weeks 1 and 3).
Consolidation Therapy: cytarabine liposome injection 50 mg, administered intrathecally (intraventricular or lumbar puncture) every 14 days for 3 doses (weeks 5, 7 and 9) followed by one additional dose at week 13.
Maintenance: cytarabine liposome injection 50 mg, administered intrathecally (intraventricular or lumbar puncture) every 28 days for 4 doses (weeks 17, 21, 25 and 29).
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
If drug related neurotoxicity develops, the dose should be reduced to 25 mg. If toxicity persists, treatment with cytarabine liposome injection should be discontinued.
Cytarabine liposome injection has the potential of producing serious toxicity. All patients receiving cytarabine liposome injection should be treated concurrently with dexamethasone to mitigate the symptoms of chemical arachnoiditis. Because toxic effects can occur at any time during therapy (although they are most likely within 5 days of drug administration), patients receiving intrathecal therapy with cytarabine liposome injection should be monitored continuously for the development of neurotoxicity. If patients develop neurotoxicity, subsequent doses of cytarabine liposome injection should be reduced, and cytarabine liposome injection should be discontinued if toxicity persists.
Some patients with neoplastic meningitis receiving treatment with cytarabine liposome injection may require concurrent radiation or systemic therapy with other chemotherapeutic agents which may increase the rate of adverse events.
Anaphylactic reactions following intravenous administration of free cytarabine have been reported.
Although significant systemic exposure to free cytarabine following intrathecal treatment is not expected, some effect on bone marrow function cannot be excluded. Systemic toxicity due to intravenous administration of cytarabine consists primarily of bone marrow suppression with leukopenia, thrombocytopenia, and anemia. Therefore, careful monitoring of the hematopoietic system is advised.
Transient elevations in CSF protein and white blood cells have been observed in patients following cytarabine liposome injection administration and have also been noted after intrathecal treatment with cytarabine.
After intrathecal administration of cytarabine liposomal, the most frequently reported reactions are nausea, vomiting and fever. Intrathecal administration of cytarabine liposomal may cause myelopathy and other neurologic toxicity and can rarely lead to a permanent neurologic deficit. Administration of intrathecal cytarabine in combination with other chemotherapeutic agents or with cranial/spinal irradiation may increase this risk of neurotoxicity.
Blockage to cerebrospinal fluid (CSF), flow may result in increased free cytarabine concentrations in the CSF and an increased risk of neurotoxicity. Therefore, as with any intrathecal cytotoxic therapy, consideration should be given to the need for assessment of CSF flow before treatment is started.
Following the intrathecal administration of cytarabine liposomal injection, central nervous system toxicity has been reported which included persistent extreme somnolence, hemiplegia, visual disturbances (including blindness, which may be total and permanent), deafness, and cranial nerve palsies. Symptoms and signs of peripheral neuropathy, such as pain, numbness, paresthesia, weakness, and impaired bowel and bladder control have also been reported. In some cases, a combination of neurological signs and symptoms have been reported as Cauda Equina Syndrome.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Data not available
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Other brands: DepoCyt