How it is administered

Cytarabine is administered as a sterile solution for injection. It can be given in several ways:

• Intravenous (IV) infusion or injection: This is the most common method, where the medication is delivered directly into a vein.
• Subcutaneous injection: The medication is injected under the skin.
• Intrathecal injection: For certain types of leukemia, cytarabine may be injected into the fluid around the spinal cord (using preservative-free preparations only).

Cytarabine is not effective if taken by mouth, as it is not absorbed well from the gastrointestinal tract.

How it works

Cytarabine is a chemotherapy medication that works by interfering with the growth of cancer cells. It is especially effective against cells that are actively dividing.

Cytarabine is classified as an antimetabolite. It acts primarily during the S-phase of the cell cycle, when DNA is being synthesized. Cytarabine is taken up by cells and converted into a form that inhibits DNA polymerase, an enzyme necessary for DNA replication. This blocks the ability of cancer cells to make new DNA, ultimately leading to cell death. Some cytarabine is also incorporated into RNA and DNA, causing further disruption of cell function. Because it targets rapidly dividing cells, it is particularly effective against certain types of blood cancers, such as leukemia.

The medication is rapidly metabolized in the body and is excreted mainly in the urine.

Who Should take it

Cytarabine is used in combination with other approved anti-cancer drugs for the treatment of certain blood cancers:

• Acute non-lymphocytic leukemia (also called acute myeloid leukemia or AML) in adults and children, for remission induction.
• Acute lymphocytic leukemia (ALL).
• Blast phase of chronic myelocytic leukemia (CML).
• Meningeal leukemia (leukemia involving the membranes around the brain and spinal cord), where it can be used intrathecally for treatment or prevention.

For chronic neutrophilic leukemia, cytarabine is not specifically indicated, but it may be considered in certain cases as part of broader leukemia treatment strategies, especially if the disease transforms into a more aggressive form.

Who should not take it

Cytarabine should not be used in patients who are hypersensitive (allergic) to the drug.

Caution is needed in patients with:

• Pre-existing bone marrow suppression from other drugs.
• Poor liver or kidney function, as they may be at higher risk for side effects.
• Pregnant women, as cytarabine can cause harm to the fetus. Women of childbearing potential should avoid becoming pregnant while on this medication.

Cytarabine should be administered only under the supervision of a healthcare provider experienced in cancer chemotherapy, with facilities available for managing complications such as infection or bleeding.

Commonly used with

Cytarabine is most often used in combination with other chemotherapy drugs. The most common combination is with daunorubicin (an anthracycline), especially for the treatment of acute myeloid leukemia (AML). It may also be used with other agents such as cyclophosphamide, vincristine, prednisone, and asparaginase, depending on the specific leukemia subtype and treatment protocol.

Commonly tested with

Cytarabine is commonly tested in combination with other chemotherapy drugs, especially daunorubicin, as part of multi-drug regimens for leukemia. It may also be tested with agents like cyclophosphamide, vincristine, prednisone, and asparaginase in clinical trials or treatment protocols for different types of blood cancers.