Fludarabine

Fludarabine is a cytotoxic chemotherapeutic agent.

Indications of Fludarabine phosphate

Treatment of patients with B-cell chronic lymphocytic leukaemia (Cll) with sufficient bone marrow reserve and who have not responded to or whose disease has progressed during or after treat­ment with at least one alkylating agent containing regimen.

Dosage of Fludarabine

Adults: 25mg/m' body surface given daily for 5 consecutive days in every 28 days by IV route.

Contraindicatlons of Fludarabine

Hypersensitivity to this drug or its components. Renally impaired patients (creatinine clearance < 30ml/minute, and patients with decompensated hemolytic anaemia. Children.

Special Precautions with Fludarabine

• When use at high doses fludarabine is associated with blindness, coma and death.
• Preexisting skin cancer.

Side effects of Fludarabine

• Myelo-suppression (neutropenia, thrombocytopenia and anaemia),
• fever, chills, and infection.
• Oedema,
• malaise,
• fatigue,
• anorexia,
• nausea,
• vomiting, and
• weakness.

Drug Interactions of Fludarabine

1. Pentostatin (deoxycoformycin): use of fludarabine in combination with pentostatin is not recommended because of a very high incidence of fatal pulmonary toxicity.
2. Adenosine uptake inhibitors: The therapeutic efficacy of fludarabine may be reduced by dipyridamole and other adenosine uptake inhibitors.

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