fludarabine (Fludara)
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Introduction
Tradename: Fludara. Fludarabine phosphate. (9-b-beta-arabinofuranosyl-2-fluoroadenine)
Indications
- treatment of chronic lymphocytic leukemia (B-cell)
- patients not responding to other agents
- low grade, non-Hodgkin's lymphoma (follicular lymphoma)
- acute myeloid leukemia[5]
Dosage
- 25 mg/m2/day IV for 5 days every 4 weeks
- 30% reduction if creatinine clearance < 70 mL/min
Lyophilized powder for injection: 50 mg
Refrigerate: use within 8 hours of reconstitution.
Pharmacokinetics
- metabolized to 2 active metabolites
- highly tissue bound
- eliminated mostly in the urine
- 1/2life is 10 hours
elimination via kidney
1/2life = 10 hours
Adverse effects
- common (> 10%)
- nausea/vomiting: mild emetic
- fever/chills, fatigue, pain, rash, diarrhea, stomatitis, GI bleeding, urinary tract infection, paresthesia, myalgia, weakness, dyspnea, non-productive cough, pneumonitis, pneumonia, infection
- myelosuppression
- less common (1-10%)
- uncommon (< 1%)
- occur with higher doses, often occurs on rechallenge.
- generally accompanied by CNS demyelination
- steroid treatment my or may not be helpful
- somnolence, blindness, coma, death, severe neurotoxicity, skin rash, metabolic acidosis, metallic taste, autoimmunehemolytic anemia (may be fatal), reversible hepatotoxicity, renal failure, hematuria, tumor lysis syndrome
- occur with higher doses, often occurs on rechallenge.
- other[3]
Mechanism of action
- antimetabolite
- interferes with DNA synthesis
More general terms
Additional terms
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ AHFS 96 Drug Information, GK McEnvoy et al (ed), American Society of Health-System Pharmacists, Bethesda, MD 1998
- ↑ 3.0 3.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 529
- ↑ 5.0 5.1 Deprecated Reference