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Cytarabine Side Effects

Medically reviewed by Last updated on Nov 23, 2022.

Applies to cytarabine: parenteral conventional cytarabine injection, parenteral conventional cytarabine powder for injection, parenteral liposomal cytarabine injection.


    Experience of Supervising Clinician
  • Conventional cytarabine: Use only under supervision of qualified clinicians experienced in therapy with antineoplastic agents.a b c c j Consider possible benefits vs known risks of cytarabine treatment.a b c j

  • Liposomal cytarabine: Use only under supervision of qualified clinicians experienced in intrathecal therapy with antineoplastic agents; adequate diagnostic and treatment facilities must be readily available for management of complications.d

    Induction Therapy with Conventional Cytarabine
  • Patients should be treated in a facility with laboratory and supportive resources sufficient to monitor drug tolerance and protect and maintain a patient compromised by drug toxicity.a b c j

  • Risk of serious adverse effects, including myelosuppression with leukopenia, thrombocytopenia, and anemia.a b c j Less serious adverse effects include nausea, vomiting, diarrhea, abdominal pain, oral ulceration, and hepatic dysfunction.a b c j (See Cautions.)

    Chemical Arachnoiditis with Intrathecal Liposomal Cytarabine
  • Chemical arachnoiditis, a syndrome manifested principally by nausea, vomiting, headache, and fever, commonly occurs.d If left untreated, may be fatal.d (See Chemical Arachnoiditis Related to Liposomal Cytarabine under Cautions.)

  • Administer dexamethasone to ameliorate symptoms and reduce incidence.d (See Liposomal Cytarabine under Dosage and Administration.)

Side effects include:

IV, sub-Q, or IM administration of conventional cytarabine: Myelosuppression, anorexia, nausea, vomiting, diarrhea, oral and anal inflammation or ulceration, hepatic dysfunction, fever, rash, thrombophlebitis, bleeding (all sites).

Intrathecal administration of conventional cytarabine: Nausea, vomiting, fever, transient headaches.

Intrathecal administration of liposomal cytarabine: Chemical arachnoiditis (neck rigidity, neck pain, meningism, nausea, vomiting, headache, fever, back pain, and/or CSF pleocytosis), asthenia, pain, confusion, somnolence.

For Healthcare Professionals

Applies to cytarabine: injectable powder for injection, injectable solution.


Very common (10% or more): Hemorrhagic conjunctivitis, corneal disorder

Common (1% to 10%): Photophobia, burning, visual disturbance, increased lacrimation, keratitis

Uncommon (0.1% to 1%): Conjunctivitis

Frequency not reported: Blindness[Ref]

Nervous system

Very common (10% or more): Somnolence

Common (1% to 10%): Decreased level of consciousness, dysarthria, nystagmus

Uncommon (0.1% to 1%): Neurotoxicity, neuritis, dizziness, headache, peripheral neuropathy, paraplegia (with intrathecal administration)

Frequency not reported: Dizziness, neurotoxicity rash, coma, convulsion, peripheral sensory neuropathy, ataxia, tremor, coma, convulsions[Ref]


Uncommon (0.1% to 1%): Chest pain

Very rare (less than 0.01%): Arrhythmia

Frequency not reported: Pericarditis, cardiomyopathy[Ref]


Very common (10% or more): Bone marrow failure, thrombocytopenia, anemia, megaloblastic anemia, leukopenia, reticulocyte count decreased

Common (1% to 10%): Bleeding (all sites), thrombophlebitis

Frequency not reported: Reticulocytopenia, neutropenia, febrile neutropenia[Ref]


Uncommon (0.1% to 1%): Anaphylactic reaction, allergic edema[Ref]


Very common (10% or more): Sepsis, infection

Frequency not reported: Viral, bacterial, fungal, parasitic, or saprophytic infections, in any location in the body (sometimes fatal)[Ref]


Uncommon (0.1% to 1%): Injection site cellulitis, injection site thrombophlebitis

Frequency not reported: Injection site pain, injection site inflammation, injection site irritation, injection site sepsis[Ref]


Very common (10% or more): Cytarabine syndrome (e.g., fever, myalgia, bone pain, occasionally chest pain, exanthema, maculopapular rash, conjunctivitis, nausea, malaise)

Uncommon (0.1% to 1%): Myalgia, joint pain[Ref]


Common (1% to 10%): Anorexia, hyperuricemia[Ref]


Frequency not reported: Personality change, confusion[Ref]


Uncommon (0.1% to 1%): Urinary retention

Frequency not reported: Amenorrhea, azoospermia[Ref]


Very common (10% or more): Hepatic function abnormal

Common (1% to 10%): Liver enzymes increased

Uncommon (0.1% to 1%): Jaundice

Frequency not reported: Liver abscess, hyperbilirubinemia, hepatomegaly, Budd-Chiari-syndrome (hepatic venous thrombosis)[Ref]


Very common (10% or more): Pneumonia, acute respiratory distress syndrome, pulmonary edema

Uncommon (0.1% to 1%): Shortness of breath[Ref]


Very common (10% or more): Pyrexia[Ref]


Uncommon (0.1% to 1%): Renal dysfunction[Ref]


Very common (10% or more): Alopecia, rash

Common (1% to 10%): Skin ulceration, erythema, bullous dermatitis, vasculitis

Uncommon (0.1% to 1%): Lentigo, palmar-plantar erythrodysesthesia syndrome, urticaria, pruritus, freckling, burning pain of palms and soles

Very rare (less than 0.01%): Neutrophilic eccrine hidradenitis

Frequency not reported: Skin bleeding[Ref]


Very common (10% or more): Stomatitis, mouth ulceration, anal ulcer, anal inflammation, diarrhea, vomiting, nausea, abdominal pain

Common (1% to 10%): Necrotizing colitis

Uncommon (0.1% to 1%): Sore throat, esophagitis, esophageal ulceration, bowel necrosis

Frequency not reported: Pancreatitis, bowel necrosis, GI ulcer, pneumatosis intestinalis, peritonitis, mucosal bleeding[Ref]

Frequently asked questions


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Cytarabine (cytarabine)." Hospira Inc (2017):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.