Generic Name: fludarabine (injection) (floo DAR a been)
Brand Name: Fludara
What is fludarabine?
Fludarabine is a cancer medication that interferes with the growth and spread of cancer cells in the body.
Fludarabine is used to treat B-cell chronic lymphocytic leukemia (CLL).
Fludarabine is usually given after other cancer medications have been tried without successful response to treatment.
Fludarabine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about fludarabine?
You should not receive fludarabine if you are also being treated with a cancer medicine called pentostatin (Nipent).
Fludarabine can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).
What should I discuss with my healthcare provider before I receive fludarabine?
You should not use this medication if you are allergic to fludarabine, or if you are also being treated with a cancer medicine called pentostatin (Nipent).
To make sure you can safely take fludarabine, tell your doctor if you have any of these other conditions:
bone marrow problems or a weak immune system;
any active infection;
a history of skin cancer; or
a history of a viral infection such as herpes zoster (shingles), Epstein-Barr, or a virus affecting the central nervous system.
Do not use fludarabine if you are pregnant. It could harm the unborn baby.
Use birth control to prevent pregnancy while you are receiving fludarabine, whether you are a man or a woman. Keep using birth control for at least 6 months after your treatment ends. Fludarabine use by either parent may cause birth defects.
It is not known whether fludarabine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are receiving fludarabine.
How is fludarabine given?
Fludarabine is injected into a vein through an IV. A healthcare provider will give you this injection.
Fludarabine is usually given daily for 5 days in a row every 28 days. Once your body has responded well to the medication, your doctor may recommend additional treatment cycles.
Fludarabine can be harmful if it gets in your eyes, mouth, or nose, or on your skin. If skin contact occurs, wash the area with soap and water or rinse the eyes thoroughly with plain water.
Fludarabine can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often.
If you need to have a blood transfusion, tell your caregivers ahead of time that you are being treated with fludarabine.
What happens if I miss a dose?
Contact your doctor if you miss an appointment for your fludarabine injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while receiving fludarabine?
This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Do not receive a "live" vaccine while using fludarabine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Fludarabine side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness;
pale or yellowed skin, dark colored urine;
cough with yellow or green mucus, stabbing chest pain, feeling short of breath;
black, bloody, or tarry stools;
coughing up blood;
lower back pain, blood in your urine;
urinating less than usual or not at all;
numbness or tingly feeling around your mouth, fast or slow heart rate, weak pulse, fainting;
muscle weakness, tightness, or contraction, overactive reflexes;
drowsiness, mood changes, increased thirst, swelling, rapid weight gain;
vision problems, headache or pain behind your eyes, changes in behavior, confusion, agitation, seizure (convulsions); or
severe blistering, peeling, and red skin rash.
Common side effects may include:
mild nausea, loss of appetite, diarrhea;
mild itching or skin rash;
muscle pain; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Fludarabine dosing information
Usual Adult Dose for Chronic Lymphocytic Leukemia:
25 mg/m2 IV once over 30 minutes for 5 days every 28 days. Following a maximal tumor response, 3 additional cycles are recommended.
40 mg/m2 once daily for 5 days every 28 days
Fludarabine phosphate can be taken either on an empty stomach or with food. The tablets have to be swallowed whole with water; they should not be chewed or broken.
Usual Adult Dose for non-Hodgkin's Lymphoma:
25 mg/m2/day for 5 days every 28 days
Usual Pediatric Dose for Malignant Disease:
Solid tumors: 7 to 9 mg/m2 IV bolus followed by 20 to 27 mg/m2/day continuous IV infusion for 5 days
Usual Pediatric Dose for Leukemia:
Acute leukemia: 10 mg/m2 IV once over 15 minutes followed by continuous IV infusion of 30.5 mg/m2/day for 5 days or 10.5 mg/m2 IV once over 15 minutes followed by continuous IV infusion of 30.5 mg/m2/day for 2 days followed by cytarabine.
Usual Pediatric Dose for Stem Cell Transplant Conditioning:
Reduced-intensity conditioning regimen prior to allogenic hematopoietic stem cell transplantation: 30 mg/m2/day for 5 days
What other drugs will affect fludarabine?
Other drugs may interact with fludarabine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
More about fludarabine
- Fludarabine tablets
- Fludarabine (Advanced Reading)
- Fludarabine Intravenous (Advanced Reading)
Related treatment guides
Where can I get more information?
- Your doctor or pharmacist can provide more information about fludarabine.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 7.05.
Date modified: January 10, 2017
Last reviewed: October 20, 2015