Nelarabine Side Effects

Medically reviewed by Drugs.com. Last updated on May 5, 2024.

Applies to nelarabine: intravenous solution.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control during treatment to keep from getting pregnant. Men should use an effective form of birth control (eg, condoms) during treatment and for at least 3 months after the last dose to prevent pregnancy in a sexual partner. If a pregnancy occurs while using the medicine, tell your doctor right away.

Do not use this medicine together with pentostatin (Nipent®). Using these medicines together may increase your chance for more serious side effects.

Nelarabine can cause serious nervous system problems. This may be more likely in patients who have had cancer treatment or radiation treatment to the head or back in the past. Check with your doctor right away if you or your child have a headache, dizziness, numbness and tingling in the hands, fingers, feet, or toes, extreme sleepiness, seizures, clumsiness or unsteadiness while walking, or weakness in the arms, hands, legs, or feet.

While you are being treated with nelarabine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Nelarabine may lower your body's resistance and there is a chance you or your child might get the infection the vaccination is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Nelarabine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause a serious reaction called tumor lysis syndrome (TLS). Call your doctor right away if you or your child have a change in how much or how often you urinate, rapid weight gain, muscle or joint pain, swelling of the feet or lower legs, or feel tired.

This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. If any of these side effects occur, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert while you are using nelarabine.

Serious side effects of nelarabine

Along with its needed effects, nelarabine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking nelarabine:

Other side effects of nelarabine

Some side effects of nelarabine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to nelarabine: intravenous solution.

Hematologic adverse events

• Very common (10% or more): Anemia (99%), leucopenia (94%), thrombocytopenia (88%), febrile neutropenia (12%)^[Ref]

Nervous system

• Very common (10% or more): Somnolence (23%), peripheral neurological disorders (sensory and motor) (21%), dizziness (21%), hypoesthesia (17%), paresthesia (15%), headache (15%)
• Common (1% to 10%): Seizures (e.g., convulsions, grand mal convulsions, status epilepticus), ataxia, balance disorder, tremor, dysgeusia
• Postmarketing reports: Demyelination and ascending peripheral neuropathies similar in appearance to Guillain-Barre syndrome^[Ref]

Other

• Very common (10% or more): Fatigue (50%), pyrexia (23%), asthenia (17%), Peripheral edema (15%), pain (11%)
• Common (1% to 10%): Abnormal gait^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (22%), diarrhea (22%), vomiting (22%), constipation (21%)
• Common (1% to 10%): Stomatitis, abdominal pain, abdominal distention^[Ref]

Respiratory

• Very common (10% or more): Cough (26%), dyspnea (20%), pleural effusion (10%)
• Common (1% to 10%): Wheezing, epistaxis, exertional dyspnea^[Ref]

Hepatic

• Very common (10% or more): Transaminases increased (10%)
• Common (1% to 10%): Hyperbilirubinemia, aspartate aminotransferase increased^[Ref]

Metabolic

• Very common (10% or more): Hypokalemia (11%)
• Common (1% to 10%): Tumor lysis syndrome, anorexia, hypoglycemia, hypocalcemia, hypomagnesemia^[Ref]

Musculoskeletal

• Common (1% to 10%): Muscle weakness, arthralgia, back pain, pain in extremity
• Rare (less than 0.1%): Rhabdomyolysis^[Ref]

Psychiatric

• Common (1% to 10%): Confusion, amnesia, insomnia, depression^[Ref]

Cardiovascular

• Common (1% to 10%): Hypotension, tachycardia^[Ref]

Dermatologic

• Very common (10% or more): Petechiae (12%)^[Ref]

Ocular

• Common (1% to 10%): Blurred vision^[Ref]

Immunologic

• Very common (10% or more): Infection (e.g., sepsis, bacteremia, pneumonia, fungal infection) (39%)^[Ref]

Renal

• Common (1% to 10%): Blood creatinine increased^[Ref]

See also:

Further information

Nelarabine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer