Your child needs to take the medicine called cytarabine (say: sye-TARE-a-been). This information sheet explains what cytarabine does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is cytarabine?
Cytarabine is medicine that is used to kill cancer cells. This medicine works by stopping the cells from dividing and making new cells.
You may hear cytarabine called ara-C, cytosine arabinoside, or by its brand name, Cytosar. Cytarabine comes in an injection form.
Before giving cytarabine to your child
Tell your doctor if your child has ever reacted badly to cytarabine or any other medication.
Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- an infection or recent exposure to infection (for example chickenpox)
- a history of kidney or liver problems
- low blood counts
How will your child get cytarabine?
Cytarabine is a clear liquid a nurse will give by needle into your child's vein (intravenously or IV) or under the skin (subcutaneously or SC). Or a doctor may give this medicine by a needle into your child's spine (intrathecal or IT). Usually your child will get this medicine in the hospital clinic or on a nursing unit.
What are the possible side effects of cytarabine?
Your child may have some of these side effects while they take cytarabine. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:
- loss of appetite
- nausea (upset stomach) and vomiting (throwing up)
- headache (especially after intrathecal injection)
- mild skin rash
Call your child's doctor during office hours if your child has any of these side effects:
- sores in the mouth or on the lips, tongue, or throat
- joint pain
- numbness or tingling in fingers, toes, or face
- swelling of feet or lower legs
- unusual tiredness or weakness
- not urinating as often
- trouble swallowing
- heartburn
- uneven heartbeat
- red or painful eyes
- yellow eyes or skin
- pain around the area of injection (where the needle was inserted)
Your child may get a group of side effects called the ara-C syndrome or drug reaction. This may happen in the 6 to 12 hours after your child gets a dose of cytarabine. The signs are similar to the signs of the flu. Call your child's doctor or nurse if your child has these signs:
- bone or muscle aches
- chest pain
- fever
- red eyes
- feeling uncomfortable, ill, or weak
- skin rash
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the Emergency Department if your child has any of these side effects:
- fever or chills
- cough or hoarseness
- black, tarry stools
- blood in urine or stool
- lower back or side pain
- pain or trouble with urinating
- severe skin rash
- shortness of breath or trouble breathing
- seizures
- abnormal speech or body movements
- confusion or memory loss
- unusual change in behavior
- difficulty moving part of the body
What safety measures should you take when your child is using cytarabine?
With low doses, cytarabine does not usually cause stomach upset (nausea). With higher doses, your child will receive medicine to prevent upset stomach and throwing up caused by cytarabine.
With high doses, your child may get red, itchy eyes while getting cytarabine. To prevent this, the doctor may order eye drops for your child. Give the eye drops regularly while your child is getting cytarabine. Keep giving the eye drops for 2 days, or 48 hours, after the last dose of cytarabine. Ask your doctor, pharmacist or nurse if your child will need these eye drops.
Your child may lose their hair. It will grow back once treatment with cytarabine stops. The colour and texture may change. Use a gentle shampoo and a soft brush.
Cytarabine may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store-bought mouthwash, as it may sting and cause dry mouth.
Cytarabine can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child shouldn't touch your child's eyes or inside their nose without washing hands first.
- Your child should not receive a permanent tattoo or any kind of body piercing.
- Your child's nurse and doctor will review with you what to do when your child has a fever.
Cytarabine can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking cytarabine.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps and rubella (MMR) and chickenpox vaccine.
There is a chance that cytarabine may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy.
If your child is sexually active it is recommended that they use some kind of birth control while receiving cytarabine. Tell the doctor right away if your child may be pregnant.
After receiving cytarabine your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with you/your child.
Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal or natural products).
What other important information should you know about cytarabine?
- Keep a list of all medications your child is on to show the doctor or pharmacist.
- Do not share your child's medicine with others and do not give anyone else's medicine to your child.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep cytarabine out of your child’s sight and reach and locked up in a safe place. If your child takes too much cytarabine, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.