Citazar
Generic Name
Cytarabine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
Variant | Unit Price | Strip Price |
---|---|---|
citazar 500 mg injection | ৳ 40.00 | N/A |
Description
Overview of the medicine
Citazar 500 mg Injection contains Cytarabine, an antimetabolite antineoplastic agent. It is used in the treatment of various forms of leukemia and lymphoma, by interfering with DNA synthesis.
Uses & Indications
Dosage
Adults
Dosage varies greatly depending on the specific leukemia, patient's condition, and concurrent chemotherapy regimens. Typical induction doses for AML range from 100 mg/m² by continuous IV infusion for 7 days, or 200 mg/m² per day for 5 days. High-dose regimens can be up to 3 g/m² every 12 hours for several doses.
Elderly
May require dose reduction due to decreased organ function and increased risk of toxicity. Close monitoring is essential.
Renal_impairment
Dose adjustment may be necessary in patients with significant renal impairment. Caution and close monitoring of hematologic and renal parameters are advised.
How to Take
Administered intravenously (as infusion or injection), subcutaneously, or intrathecally. Intravenous infusion is common for systemic therapy. Preparation and administration must be done by trained personnel following aseptic techniques.
Mechanism of Action
Cytarabine is a pyrimidine analogue that is converted intracellularly to its active triphosphate form (ara-CTP). Ara-CTP inhibits DNA polymerase, thereby blocking DNA synthesis and repair. It also incorporates into DNA and RNA, disrupting nucleic acid structure and function, ultimately leading to cell death.
Pharmacokinetics
Onset
Varies depending on regimen and type of leukemia; typically within days.
Excretion
Primarily renal excretion of ara-U; about 80% of dose excreted within 24 hours.
Half life
Biphasic elimination; initial phase ~10 minutes, terminal phase ~1-3 hours.
Absorption
Rapidly absorbed after subcutaneous administration; intravenous administration results in rapid distribution.
Metabolism
Primarily deaminated by cytidine deaminase in the liver and kidneys to inactive uracil arabinoside (ara-U).
Side Effects
Contraindications
- Hypersensitivity to Cytarabine
- Severe pre-existing bone marrow depression
- Severe liver or kidney impairment (relative contraindication, requires careful dose adjustment)
Drug Interactions
Digoxin
Reduced oral digoxin absorption, monitor digoxin levels.
Gentamicin
Antagonism of gentamicin activity against Klebsiella pneumoniae.
Fluorouracil
May increase cytotoxicity when administered sequentially.
Other Myelosuppressive Agents/Radiation Therapy
Increased risk of severe myelosuppression and other toxicities.
Storage
Store at controlled room temperature (20°C to 25°C), away from light. Do not freeze.
Overdose
There is no specific antidote for cytarabine overdose. Management involves supportive care, including close monitoring of hematologic parameters and prompt treatment of infections, bleeding, or other toxicities. High doses can lead to profound myelosuppression, neurotoxicity, and GI toxicity.
Pregnancy & Lactation
Pregnancy Category D: Cytarabine can cause fetal harm when administered to a pregnant woman. It is contraindicated during pregnancy. Women of childbearing potential should be advised to avoid becoming pregnant. Lactation: It is unknown whether cytarabine is excreted in human milk. Breastfeeding should be discontinued during treatment due to the potential for serious adverse reactions in the infant.
Side Effects
Contraindications
- Hypersensitivity to Cytarabine
- Severe pre-existing bone marrow depression
- Severe liver or kidney impairment (relative contraindication, requires careful dose adjustment)
Drug Interactions
Digoxin
Reduced oral digoxin absorption, monitor digoxin levels.
Gentamicin
Antagonism of gentamicin activity against Klebsiella pneumoniae.
Fluorouracil
May increase cytotoxicity when administered sequentially.
Other Myelosuppressive Agents/Radiation Therapy
Increased risk of severe myelosuppression and other toxicities.
Storage
Store at controlled room temperature (20°C to 25°C), away from light. Do not freeze.
Overdose
There is no specific antidote for cytarabine overdose. Management involves supportive care, including close monitoring of hematologic parameters and prompt treatment of infections, bleeding, or other toxicities. High doses can lead to profound myelosuppression, neurotoxicity, and GI toxicity.
Pregnancy & Lactation
Pregnancy Category D: Cytarabine can cause fetal harm when administered to a pregnant woman. It is contraindicated during pregnancy. Women of childbearing potential should be advised to avoid becoming pregnant. Lactation: It is unknown whether cytarabine is excreted in human milk. Breastfeeding should be discontinued during treatment due to the potential for serious adverse reactions in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored correctly.
Availability
Hospital pharmacies, specialized oncology centers
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Patent expired (generic available)
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for acute leukemias and lymphomas, both as monotherapy and in combination regimens. Ongoing trials explore new combinations and formulations.
Lab Monitoring
- Complete Blood Count (CBC) with differential (frequently during and after therapy)
- Liver function tests (LFTs)
- Kidney function tests (renal panel)
- Serum uric acid levels
- Neurological assessment
Doctor Notes
- High potential for myelosuppression, requiring aggressive supportive care.
- Monitor for 'cytarabine syndrome' (fever, myalgia, rash, conjunctivitis) and manage with corticosteroids.
- Intrathecal administration requires preservative-free formulation.
- Careful handling and disposal as it is a cytotoxic agent.
Patient Guidelines
- Report any signs of infection, bleeding, or unusual bruising immediately.
- Report persistent nausea, vomiting, or diarrhea.
- Maintain good oral hygiene to prevent mucositis.
- Avoid live vaccines during treatment.
- Use effective contraception during and for some time after treatment.
Missed Dose Advice
Due to the strict scheduling of chemotherapy, a missed dose should be reported to the healthcare provider immediately. Do not double the dose. The healthcare team will advise on rescheduling.
Driving Precautions
Cytarabine can cause fatigue, dizziness, and neurological side effects that may impair the ability to drive or operate machinery. Patients should be advised to avoid such activities if they experience these symptoms.
Lifestyle Advice
- Maintain a balanced diet and stay hydrated.
- Get adequate rest.
- Avoid exposure to people with infections.
- Discuss fertility preservation options before starting treatment.
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