Fludarabine

Decompensated haemolytic anaemia. Severe renal impairment (CrCl <30 mL/min). Lactation. Concomitant use w/ pentostatin.

Patient w/ severe impairment of bone marrow function, immunodeficiency, history of opportunistic infections. Renal (CrCl 30-70 mL/min) and hepatic impairment. Pregnancy. Patient Counselling This drug may cause confusion, fatigue and visual disturbances, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CBC w/ differential and platelet count, serum creatinine and albumin, uric acid, AST, ALT; signs of infection, neurotoxicity and tumour lysis syndrome.

Significant: Skin cancer (new onset or exacerbation). Nervous: Agitation, confusion, seizure, insomia, coma, peripheral neuropathy. CV: Oedema, angina, CHF, arrhythmia, supraventricular tachycardia, MI, DVT, phlebitis, TIA, aneurysm, chest pain. GI: Nausea, vomiting, diarrhoea, anorexia, stomatitis, GI bleeding, oesophagitis, constipation, mucositis, dysphagia, pancreatitis. Resp: Cough, dyspnoea, upper resp infection, pharyngitis, allergic pneumonitis, haemoptysis, bronchitis, hypoxia, interstitial pulmonary infiltrate. Hepatic: Abnormal LFT, cholelithiasis, hepatic failure, reversible hepatotoxicity. Genitourinary: UTI, dysuria, haematuria, urinary hesitancy, renal failure, proteinuria. Musculoskeletal: Arthralgia. Ophthalmologic: Visual disturbance. Dermatologic: Skin toxicity (e.g. maculopapular rash). Immunologic: Infection, anaphylaxis. Others: Fever, weakness, fatigue, malaise, pain, dehydration.
Potentially Fatal: Myelosuppression (e.g. thrombocytopenia, anaemia, neutropenia), autoimmune phenomena (e.g. haemolytic anaemia, autoimmune thrombocytopenia/thrombocytopenic purpura, Evan syndrome, acquired haemophilia), serious opportunistic infections, progressive multifocal leukoencephalopathy, tumour lysis syndrome, severe pulmonary toxicity. Rarely, neurotoxicity, transfusion-related graft-versus-host disease.

Reduced therapeutic effect w/ dipyridamole and other inhibitors of adenosine uptake. Cytarabine may reduce the metabolic activation of fludarabine. May diminish the effect of live vaccines.

Cytotoxic Chemotherapy

L01BB05 - fludarabine ; Belongs to the class of antimetabolites, purine analogues. Used in the treatment of cancer.