How it is administered

Cytarabine is given as an injection and is not effective if taken by mouth. It can be administered in several ways:

• Intravenous (IV) infusion or injection: Given directly into a vein, either as a slow drip (infusion) or a quick injection.
• Subcutaneous injection: Injected under the skin.
• Intrathecal injection: Injected into the fluid around the spinal cord (for certain types of leukemia involving the central nervous system). Only preservative-free preparations are used for this purpose.

The exact schedule and method depend on the specific treatment plan and the type of blood cancer being treated.

How it works

Cytarabine is a type of chemotherapy medicine known as an antimetabolite. It works by interfering with the DNA of cancer cells, specifically during the phase when the cell is making new DNA (the S-phase of the cell cycle). By blocking an enzyme called DNA polymerase, cytarabine prevents cancer cells from multiplying and growing.

Cytarabine is especially effective against rapidly dividing cells, which is why it is commonly used in blood cancers like leukemia. It can also suppress the immune system, which may be helpful in treating certain cancers but also increases the risk of infections. The drug is processed by the body quickly, so it is usually given in repeated doses or continuous infusions to maintain its effectiveness.

Who Should take it

Cytarabine is mainly used for patients with certain types of blood cancers, including:

• Acute non-lymphocytic leukemia (also known as acute myeloid leukemia or AML) in both adults and children, usually in combination with other chemotherapy drugs.
• Acute lymphocytic leukemia (ALL) and the blast phase of chronic myelocytic leukemia (CML).
• Meningeal leukemia: Cytarabine may be given intrathecally (into the spinal fluid) for the prevention or treatment of leukemia involving the central nervous system.

Your doctor will decide if cytarabine is appropriate for you based on your specific diagnosis, overall health, and treatment goals.

Who should not take it

Cytarabine should not be used by patients who are allergic to the drug or any of its ingredients. It should be used with extreme caution in people with pre-existing bone marrow suppression, as it can further lower blood cell counts and increase the risk of infection and bleeding.

Pregnant women should avoid cytarabine, as it can cause harm to the developing baby. Women of childbearing age should use effective contraception during treatment. People with severe liver or kidney problems may need dose adjustments or may not be able to use cytarabine safely. Always discuss your full medical history with your doctor before starting treatment.

Commonly used with

Cytarabine is most often used in combination with other chemotherapy drugs to increase its effectiveness. Common partners include:

• Daunorubicin or other anthracyclines (as in the standard "7+3" regimen for AML)
• Cyclophosphamide
• Vincristine
• Prednisone
• Methotrexate (especially for central nervous system involvement)

The exact combination depends on the type of leukemia and the treatment protocol.

Commonly tested with

Cytarabine is frequently tested in clinical trials with other chemotherapy agents, targeted therapies, and supportive care medicines. It is often studied in combination with:

• Daunorubicin (as in VYXEOS, a fixed combination liposomal formulation)
• Anthracyclines
• Other antimetabolites or cytotoxic agents
• Supportive medications to manage side effects, such as anti-nausea drugs, antibiotics, and growth factors to support blood counts.

Clinical trials may also explore new dosing schedules or routes of administration for cytarabine.