Cybine
Generic Name
Cytarabine
Manufacturer
Beacon Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cybine 500 mg injection | ৳ 900.00 | N/A |
Description
Overview of the medicine
Cybine 500 mg Injection contains Cytarabine, an antimetabolite antineoplastic agent used in the treatment of various forms of cancer, particularly leukemias and lymphomas. It works by interfering with the growth of cancer cells, which are eventually destroyed by the body.
Uses & Indications
Dosage
Adults
Dosage varies greatly depending on the specific leukemia or lymphoma, treatment regimen (e.g., induction, consolidation, maintenance), and route of administration (IV, SC, IT). Common IV doses range from 100 mg/m² to 3000 mg/m² per cycle. Administered under strict medical supervision.
Elderly
Elderly patients may require reduced doses or closer monitoring due to decreased renal/hepatic function and potential for increased toxicity. Dosage adjustments based on patient's overall health and comorbidities.
Renal_impairment
Dosage reduction may be necessary in patients with significant renal impairment, as the drug and its metabolites are primarily renally excreted. Close monitoring of renal function is advised.
How to Take
Cybine 500 mg Injection is administered intravenously (IV) as an infusion or bolus, subcutaneously (SC), or intrathecally (IT) depending on the indication. It should always be prepared and administered by qualified healthcare professionals.
Mechanism of Action
Cytarabine is a pyrimidine analog that inhibits DNA synthesis by competitive inhibition of DNA polymerase. It also incorporates into both DNA and RNA, leading to structural damage and disruption of cellular replication and repair processes. This action is most pronounced during the S-phase of the cell cycle.
Pharmacokinetics
Onset
Rapid following intravenous administration, typically within minutes.
Excretion
Approximately 80% of the dose is excreted in the urine as Ara-U within 24 hours. Minimal active drug is excreted unchanged.
Half life
Biphasic elimination with an initial distribution half-life of about 10 minutes and a terminal elimination half-life of 1-3 hours.
Absorption
Rapidly deaminated after IV administration. Oral bioavailability is low due to extensive first-pass metabolism.
Metabolism
Primarily metabolized in the liver and kidneys by cytidine deaminase to the inactive metabolite uracil arabinoside (Ara-U).
Side Effects
Contraindications
- Known hypersensitivity to Cytarabine or any component of the formulation.
- Pre-existing bone marrow depression not caused by malignancy (unless the risk is justified).
Drug Interactions
Digoxin
Reduced steady-state plasma concentrations of digoxin; monitor digoxin levels.
Gentamicin
Antagonistic effect against Klebsiella pneumoniae has been reported.
Fluorouracil
Increased neurotoxicity when used intrathecally with Cytarabine.
Live vaccines
Avoid due to immunosuppression.
Other Myelosuppressive Agents
Increased risk of severe myelosuppression.
Storage
Store unopened vials at controlled room temperature (20-25°C) and protect from light. Reconstituted solution storage depends on specific manufacturer instructions, often requiring refrigeration (2-8°C) for a limited time.
Overdose
There is no known antidote for Cytarabine overdose. Management involves supportive care and close monitoring of hematological and neurological parameters. Discontinuation of therapy and prompt symptomatic treatment are crucial.
Pregnancy & Lactation
Pregnancy Category D: Cytarabine can cause fetal harm when administered to a pregnant woman. It is contraindicated during pregnancy. Breastfeeding is not recommended during treatment due to the potential for serious adverse reactions in the infant.
Side Effects
Contraindications
- Known hypersensitivity to Cytarabine or any component of the formulation.
- Pre-existing bone marrow depression not caused by malignancy (unless the risk is justified).
Drug Interactions
Digoxin
Reduced steady-state plasma concentrations of digoxin; monitor digoxin levels.
Gentamicin
Antagonistic effect against Klebsiella pneumoniae has been reported.
Fluorouracil
Increased neurotoxicity when used intrathecally with Cytarabine.
Live vaccines
Avoid due to immunosuppression.
Other Myelosuppressive Agents
Increased risk of severe myelosuppression.
Storage
Store unopened vials at controlled room temperature (20-25°C) and protect from light. Reconstituted solution storage depends on specific manufacturer instructions, often requiring refrigeration (2-8°C) for a limited time.
Overdose
There is no known antidote for Cytarabine overdose. Management involves supportive care and close monitoring of hematological and neurological parameters. Discontinuation of therapy and prompt symptomatic treatment are crucial.
Pregnancy & Lactation
Pregnancy Category D: Cytarabine can cause fetal harm when administered to a pregnant woman. It is contraindicated during pregnancy. Breastfeeding is not recommended 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 for unopened vials when stored as recommended. Reconstituted solutions have limited stability (e.g., 8-48 hours) depending on the diluent and storage conditions.
Availability
Available in hospitals and specialized pharmacies
Approval Status
Approved in many countries globally
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Cytarabine has been extensively studied in clinical trials for various hematological malignancies. Ongoing research explores new combinations, dosing schedules, and its role in emerging therapies for resistant or relapsed cancers.
Lab Monitoring
- Complete Blood Count (CBC) with differential (daily or frequently during induction)
- Liver function tests (LFTs)
- Renal function tests (BUN, creatinine)
- Neurological assessment (especially with high doses or intrathecal use)
- Serum uric acid (due to tumor lysis syndrome risk)
Doctor Notes
- Confirm bone marrow reserve before initiating therapy and monitor frequently.
- Adjust dosage carefully in patients with renal or hepatic impairment.
- Prophylactic antiemetics are crucial for managing GI toxicity.
- Be vigilant for 'Cytarabine syndrome' and manage with corticosteroids.
- Provide patient education on signs of infection and bleeding.
Patient Guidelines
- Report any unusual bleeding, bruising, signs of infection (fever, chills), or severe fatigue immediately to your healthcare team.
- Maintain good oral hygiene to prevent stomatitis.
- Stay well-hydrated and follow dietary recommendations.
- Avoid close contact with people who are sick or have infections.
- Understand that chemotherapy can have significant side effects, and your healthcare team will manage them.
Missed Dose Advice
As this medicine is administered by a healthcare professional in a hospital or clinic setting, it is highly unlikely that a dose will be missed. If you have concerns, discuss them with your care team.
Driving Precautions
Cybine can cause neurological side effects such as dizziness, confusion, or visual disturbances, especially with high doses. Patients should be advised to avoid driving or operating machinery if they experience these effects.
Lifestyle Advice
- Adopt a balanced diet rich in nutrients and vitamins.
- Engage in light physical activity as tolerated, if approved by your doctor.
- Ensure adequate rest and manage stress effectively.
- Avoid alcohol and tobacco products.
- Use contraception during and for a period after treatment, as advised by your doctor.
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