Fludarabine
Non-Hodgkin Lymphoma, B-Cell Chronic Lymphocytic Leukemia ... show more
.svg)
Drug Status
Government Approvals
UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
Definite
Pharmaceutical Class
Nucleoside Metabolic Inhibitor
Controlled Drug Substance
No
Fludarabine
Summary
Fludarabine is primarily used to treat B-cell chronic lymphocytic leukemia (CLL) in adults. This is a type of cancer that affects your white blood cells.
Fludarabine works by interfering with DNA synthesis. This means it stops cancer cells from growing and dividing, which leads to their death.
The recommended dose for adults is 40 mg/m body surface area, taken orally for 5 consecutive days every 28 days. It is not recommended for use in children.
Common side effects include myelosuppression, neutropenia, thrombocytopenia, anemia, infection, fever, fatigue, weakness, nausea, vomiting, and diarrhea. More serious effects include severe bone marrow suppression, autoimmune disorders, and neurotoxicity.
Fludarabine should not be used if you have an allergy to it, severe kidney impairment, decompensated hemolytic anemia, or if you're breastfeeding. It also carries warnings for severe bone marrow suppression, autoimmune disorders, neurotoxicity, and tumor lysis syndrome.
Indications and Purpose
How does Fludarabine work?
Fludarabine is a purine analogue that interferes with DNA synthesis. Once inside the body, it is converted into an active form that inhibits enzymes involved in DNA replication. This disruption prevents cancer cells from growing and dividing, ultimately leading to their death.
Is Fludarabine effective?
Clinical trials have shown that Fludarabine is effective in treating B-cell chronic lymphocytic leukemia (CLL). In a phase III trial, Fludarabine demonstrated higher overall response rates and complete response rates compared to chlorambucil, with longer duration of response and time to progression. These results support its effectiveness in managing CLL.
What is Fludarabine?
Fludarabine is primarily used to treat B-cell chronic lymphocytic leukemia (CLL) in adults. It works by interfering with DNA synthesis, which inhibits the growth of cancer cells. Fludarabine is a purine analogue that is converted into an active form inside the body, disrupting the replication of cancerous cells and leading to their death.
Directions for Use
For how long do I take Fludarabine?
Fludarabine is typically administered until the best response is achieved, which is usually around 6 cycles. The duration of treatment depends on the success and tolerability of the drug. Treatment should be discontinued once complete or partial remission is achieved.
How do I take Fludarabine?
Fludarabine can be taken either on an empty stomach or with food. The tablets should be swallowed whole with water and should not be chewed or broken. There are no specific food restrictions mentioned, but it is important to follow your doctor's instructions regarding diet and medication use.
How long does it take for Fludarabine to start working?
Fludarabine can induce a response as early as the first week of treatment, especially in patients with large tumor burdens. However, the full effect and best response are typically achieved after several cycles of treatment, usually around 6 cycles.
How should I store Fludarabine?
Fludarabine should be stored in its original package to protect it from moisture. It should not be stored above 25°C and should not be refrigerated. Proper storage ensures the medication remains effective and safe to use.
What is the usual dose of Fludarabine?
For adults, the recommended dose of Fludarabine is 40 mg/m² body surface area, given daily for 5 consecutive days every 28 days by oral route. This dose is 1.6 times the recommended intravenous dose. The safety and efficacy of Fludarabine in children below the age of 18 years have not been established, and it is not recommended for use in children.
Warnings and Precautions
Can Fludarabine be taken safely while breastfeeding?
Fludarabine is contraindicated during breastfeeding due to the potential for serious adverse reactions in breast-fed infants. It is not known whether Fludarabine or its metabolites are excreted in human milk, but preclinical data suggest transfer from maternal blood to milk. Women should not breastfeed while taking this medication.
Can Fludarabine be taken safely while pregnant?
Fludarabine is not recommended during pregnancy due to its genotoxic and teratogenic potential. It has been shown to cause fetal harm in animal studies. Women of childbearing potential should use effective contraception during and for at least 6 months after treatment. If pregnancy occurs, the potential benefits and risks should be carefully considered.
Can I take Fludarabine with other prescription drugs?
Fludarabine should not be used in combination with pentostatin due to a high incidence of fatal pulmonary toxicity. Dipyridamole and other inhibitors of adenosine uptake may reduce the therapeutic efficacy of Fludarabine. Patients should inform their doctor of all medications they are taking to avoid potential interactions.
Is Fludarabine safe for the elderly?
For elderly patients, especially those over 75 years, caution is advised when using Fludarabine due to limited data on its use in this age group. In patients aged 65 years or older, creatinine clearance should be measured before starting treatment to assess kidney function. This is important because impaired renal function can affect how the drug is processed in the body.
Is it safe to exercise while taking Fludarabine?
Fludarabine may cause fatigue and weakness, which can limit the ability to exercise. If you experience these side effects, it is advisable to rest and avoid strenuous activities. Consult your doctor for personalized advice on managing these symptoms and determining safe levels of physical activity.
Who should avoid taking Fludarabine?
Important warnings for Fludarabine include severe bone marrow suppression, autoimmune disorders, neurotoxicity, and tumor lysis syndrome. Contraindications include hypersensitivity to the drug, renal impairment with creatinine clearance <30 ml/min, decompensated hemolytic anemia, and lactation. Patients should be closely monitored for signs of toxicity and adverse reactions.
Forms / Brands
