Cytarabine Side Effects
Medically reviewed by Drugs.com. Last updated on Nov 23, 2022.
Applies to cytarabine: parenteral conventional cytarabine injection, parenteral conventional cytarabine powder for injection, parenteral liposomal cytarabine injection.
Warning
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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
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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.)
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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.
Ocular
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]
Cardiovascular
Uncommon (0.1% to 1%): Chest pain
Very rare (less than 0.01%): Arrhythmia
Frequency not reported: Pericarditis, cardiomyopathy[Ref]
Hematologic
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]
Hypersensitivity
Uncommon (0.1% to 1%): Anaphylactic reaction, allergic edema[Ref]
Immunologic
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]
Local
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]
Musculoskeletal
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]
Metabolic
Common (1% to 10%): Anorexia, hyperuricemia[Ref]
Psychiatric
Frequency not reported: Personality change, confusion[Ref]
Genitourinary
Uncommon (0.1% to 1%): Urinary retention
Frequency not reported: Amenorrhea, azoospermia[Ref]
Hepatic
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]
Respiratory
Very common (10% or more): Pneumonia, acute respiratory distress syndrome, pulmonary edema
Uncommon (0.1% to 1%): Shortness of breath[Ref]
Other
Very common (10% or more): Pyrexia[Ref]
Renal
Uncommon (0.1% to 1%): Renal dysfunction[Ref]
Dermatologic
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]
Gastrointestinal
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
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References
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.