• Acute Myeloid Leukemia (AML) – induction and consolidation therapy

Dose:

Induction: 100 mg/m² IV daily for 7 days (standard dose)

Consolidation: 1–3 g/m² IV every 12 hours for 3–5 days, usually after remission

  • Acute Lymphocytic Leukemia (ALL) – in combination with other agents

Dose:Combination regimens: Cytarabine is often given 100–200 mg/m² IV daily for 7 days, combined with other agents like methotrexate or vincristine

  • Chronic Myelogenous Leukemia (CML) – blast crisis

Dose:Blast crisis: 400–1000 mg/m² IV daily for 7 days (combined with other chemotherapies)

  • Non-Hodgkin Lymphoma (NHL) – in combination therapy
  • Meningeal Leukemia – intrathecal administration

Dose:Intrathecal injection: 50–75 mg every 2 weeks for consolidation or until remission achieved

  • IV infusion vials: 100 mg/mL, 200 mg/mL
  • Oral tablets: (rare, but occasionally used in off-label settings)
  • Intrathecal (for cerebrospinal fluid administration)
  • Injectable formulations: Lyophilized powder for reconstitution (usually for infusion)
  • IV infusion: Administer over 1–2 hours, depending on dose
  • Intrathecal: Administer via lumbar puncture for direct CSF injection
  • Hydration: Use pre- and post-treatment hydration to prevent renal toxicity
  • Antiemetics: Often co-administered due to high emetogenic potential
  • Monitor blood counts regularly due to myelosuppressive effects
  • Class: Antimetabolite (pyrimidine analogue)
  • Mechanism of Action:
    • Converted to ara-CTP (active form) → inhibits DNA polymerase → interferes with DNA replication → induces apoptosis in rapidly dividing cells
    • S-phase specific (acts on cells in DNA synthesis phase)
    • Primarily affects hematologic malignancies and dividing cells
  • Half-life: ~1–3 hours (depends on dose and route)
  • Excretion: Renal (primarily as metabolites)
  • Myelosuppression (neutropenia, thrombocytopenia, anemia)
  • Nausea/vomiting (high emetogenic potential)
  • Mucositis (oral ulcers, GI tract issues)
  • Fatigue
  • Alopecia (hair loss, generally reversible)
  • Rash
  • Liver enzyme elevation (mild)
  • Hypersensitivity to cytarabine or any of its components
  • Severe bone marrow suppression (unless part of treatment)
  • Active infections (requires treatment before chemotherapy)
  • Pregnancy (category D)
  • Myelosuppressive agents: Additive bone marrow suppression (e.g., other chemotherapy agents, certain immunosuppressants)
  • Hepatotoxic drugs: Combined hepatotoxicity risk
  • Live vaccines: Due to immunosuppression, live vaccines should be avoided during and for several months after cytarabine treatment
  • Folic acid: May interfere with cytarabine’s effects (avoid excessive supplementation)

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Biobin 100mg/mL Injection 1’s Biochem Pharma Sai Pharma
Cytosar 1000mg/5mL Injection 1’s Pfizer Labs Pfizer Labs