Common brand names

• Cytosar-U

How it is administered

Cytarabine is administered by injection. It can be given intravenously (into a vein), subcutaneously (under the skin), or intrathecally (into the spinal fluid, using preservative-free formulations only). The medication is not effective if taken orally.

It is available as a sterile solution in various concentrations and vial sizes, suitable for single or multiple doses, depending on the formulation. The exact method, dose, and schedule will depend on your treatment plan and the type of blood cancer being treated.

How it works

Cytarabine is a type of chemotherapy known as an antimetabolite. It works by interfering with the DNA synthesis of rapidly dividing cells, such as cancer cells. Cytarabine is most active during the S-phase of the cell cycle, which is when DNA is being replicated.

Once inside the body, cytarabine is converted into an active form that inhibits DNA polymerase, an enzyme essential for DNA replication. This prevents cancer cells from multiplying and can lead to their death. Cytarabine also causes some incorporation into RNA and DNA, leading to further disruption of cellular function. Because it targets rapidly dividing cells, it also affects some normal cells, which can lead to side effects.

Who should take it

Cytarabine is used in combination with other approved anti-cancer drugs for the treatment of certain blood cancers. It is indicated for remission induction in acute non-lymphocytic leukemia (including acute myeloid leukemia) in adults and children. It is also used in the treatment of acute lymphocytic leukemia and the blast phase of chronic myelocytic leukemia.

Additionally, cytarabine can be administered intrathecally (into the spinal fluid) for the prevention and treatment of meningeal leukemia (leukemia involving the central nervous system). Your doctor will determine if cytarabine is appropriate for your specific diagnosis and treatment goals.

Who should not take it

Cytarabine should not be used by anyone who has a known hypersensitivity or allergy to the drug. It should be used with great caution in patients who have pre-existing bone marrow suppression, as it is a potent bone marrow suppressant itself.

Patients with severe liver or kidney impairment may need dose adjustments or may not be suitable candidates for cytarabine, as these organs are important for processing and eliminating the drug. Pregnant women should avoid cytarabine due to the risk of harm to the developing fetus. Always inform your healthcare provider about your full medical history before starting cytarabine.

Commonly used with

Cytarabine is most often used in combination with other chemotherapy drugs, such as daunorubicin, to enhance its effectiveness in treating blood cancers. It is a key component of many standard induction regimens for acute myeloid leukemia and other leukemias.

Your treatment plan may include additional supportive medications to help manage side effects, such as anti-nausea drugs, antibiotics, and growth factors to support blood counts.

Commonly tested with

Cytarabine is frequently tested in combination with other chemotherapy agents, such as daunorubicin, as part of multi-drug regimens in clinical trials for leukemia and other blood cancers. It is also evaluated with supportive care medications to reduce side effects and improve outcomes.

Clinical trials may explore different dosing schedules, routes of administration, and combinations with newer targeted therapies or immunotherapies.