Ara-C  

Brand name: Cytosar-U®  

Generic name: Cytarabine 

Other names: Arabinosylcytosine 

Therapeutic Class: antimetabolite 

Manufacturer / Distributor:  Pfizer 

 Availability:  Ara-C is available by prescription only 

Indications: Ara-C in used alone or in combination with other chemotherapy agents in the treatment of: 

• Certain types of leukemia 
• Non-Hodgkin’s lymphoma 

Ara-C is sometimes used to treat other medical conditions not mentioned in this article; talk to your doctor or pharmacist for more information.  

Dosage form:  Ara-C is given by injection into a vein (intravenous), injection into the muscle (intramuscular injection) or injection into the spinal cord (intrathecal infusion) 

Dosage: t o recommend an effective dose of Ara-C, your doctor will base on your health in general, other drugs you are taking, type of cancer you have, and your body mass area (BSA). The reactions of your body to the drug can determine if the treatment needs to be adjusted or stopped. Usually, Ara-C are administered daily over a period of time, which will be determined by your oncologist according to condition and your body's reaction to the medication. In general, each treatment cycle is followed by a pause.  

Ara-C comes in a solution form to be taken by intravenous, intramuscular or intrathecal infusion. The drug is administered in a hospital or a medical center having sterilization equipment available for its preparation. Either in hospital or a health center, Ara-C must be prepared and administered by medical specialists who have experience in chemotherapy drugs. Ara-C can seriously decrease the number of blood cells in your bone marrow; a special monitoring during the treatment is necessary.  

Overdose: Ara-C is administered in hospital by professionals; the risk of overdose is virtually nonexistent. In case that accidental overdose happens, immediate medical attention is required. Ara-C overdose may cause severe and even fatal health problems. There is no unique treatment for Ara-C overdose; treatment is symptomatic and close monitoring.    

Missing dose: the fact that Ara-C is administered in hospital, it is basically difficult for you to miss a dose if you respect your doctor appointment. If for some reasons you cannot be present at the hospital for the therapy, contact your oncologist before the date scheduled for the treatment. Do not discontinue the therapy because you experience side effects; side effects do not mean the drug does not work you. In fact, most patients being treated with Ara-C develop adverse effects. 

Mechanism of action (MOA): Ara-C works by selectively inhibiting DNA synthesis. Once their DNAs are damaged, cancer cells (also healthy normal) which require DNA to reproduce become unable to multiply. Unfortunately some rapidly dividing healthy cells are damaged by Ara-C. 

Contraindications : Ara-C is contraindicated, or should be used with precaution in these conditions:  

• allergy to Ara-C or any of its components  
• pregnant women  
• Women who are breast-feeding.   

Ara-C can affect the liver and/or kidney functions. A strict hematologic, hepatic (liver), renal (kidney) monitoring is necessary during the therapy, particularly during the induction phase. It is also important that your doctor regularly do tests to check your bone marrow status.

Interactions:  talk you to your doctor before taking vitamins, nutritional supplements, or St. John wort. Some drugs can alter the effects of Ara-C and increased risk of developing side effects. Consult your doctor before taking the following medicines:  

• vaccins  
• Ganciclovir , an antiviral drug  
• Amphotericin B, a polyene antifungal drug 
• Azathioprine , an immune system inhibitor 
• Digoxin, a medication used in the treatment of several heart conditions 
• Plicamycin , a chemotherapy used to stop the growth of cancer cells 
• Amiodarone , a medication used to treat irregular heart beat 
• Barbiturates, depressant drug that causes relaxation and sleepiness 
• Cimetidine , a drug used to inhibit the production of acid in the stomach 
• Colchicines , a medication used to treat pain associated with gouty arthritis 
• Cyclophosphamide (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers  
• Cyclophosphamide (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers.  

 Side effects: b y attacking the cancer cells, Ara-C also attack some normal cells that multiply quickly, which can cause various adverse effects. Most common Ara-C side effects include: 

·         joint pain

·         hair loss

·      headache

·      weakness

·      decreased appetite

·      weight loss

·      nausea and vomiting

·      Cramp or tingling in the hands or feet.

Ara-C can cause serious side effects which require medical attention; contact your doctor immediately if you experience any of these symptoms:   

·         painful urination  

·         bloody urine  

·         muscle weakness 

·         persistent cough and sore throat  

·         abdominal pain  

·         blurred vision 

·         black, tarry stools

·         unusual bruising or bleeding

·      yellowing of the skin or eyes

·      swelling and pain at the injection site

·      Fever, which can be a sign of infection.