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Fludara Information

Fludara (fludarabine phosphate) injection is a chemotherapy medication used for the treatment of adult patients with B-cell chronic lymphocytic leukemia (CLL). It is indicated for use as a component of a combination regimen and for patients whose disease has not responded to or has progressed during treatment with at least one alkylating-agent-containing regimen. Fludarabine phosphate is a nucleoside metabolic inhibitor that works by interfering with DNA synthesis, specifically by inhibiting DNA polymerase alpha, ribonucleotide reductase, and DNA primase. This disruption prevents cancer cells from replicating and growing, ultimately leading to their death. This results in a decrease in the number of cancerous white blood cells in the bone marrow and blood. Fludara delivers the active substance fludarabine phosphate, which specifically targets the machinery of cell division, helping to control the progression of chronic lymphocytic leukemia.

Fludara Side Effects

The most common side effects of Fludara may include myelosuppression (low blood cell counts, leading to neutropenia, thrombocytopenia, or anemia), fever, infections, fatigue, loss of appetite, edema (swelling), nausea, vomiting, weakness, and pain. Call your doctor right away if you have any of the serious side effects, such as:
• Autoimmune cytopenias: life-threatening and sometimes fatal autoimmune hemolytic anemia (unusual tiredness, fast or pounding heartbeat, pale or yellowish skin), autoimmune thrombocytopenia/idiopathic thrombocytopenic purpura (ITP), Evans syndrome, or acquired hemophilia
• Bloody diarrhea
• Chest pain
• Progressive Multifocal Leukoencephalopathy (PML): weakness, paralysis, vision changes, speech problems, or confusion
• Pulmonary toxicity (lung problems): new or worsening cough, shortness of breath, fever (mainly if used with pentostatin, which is not recommended due to the high incidence of fatal pulmonary toxicity)
• Severe bone marrow suppression: easy bruising, unusual bleeding (e.g., nosebleeds, bleeding gums), unusual tiredness, pale skin, signs of infection (e.g., fever, chills, sore throat that doesn't go away)
• Severe central nervous system (CNS) toxicity: vision changes (including blindness), seizures, agitation, confusion, coma, or death (these can be delayed and occur weeks after treatment)
• Signs of an allergic reaction, such as rash, breathing difficulties, itching or swelling of the face, tongue, or throat
• Tumor Lysis Syndrome (TLS): lower back or side pain, painful urination, pink or bloody urine, change in the amount of urine, muscle spasms or weakness

Fludara Precautions

Do not use Fludara if you are allergic to fludarabine phosphate or other ingredients in this medication. Fludara is contraindicated in patients with severe renal impairment (creatinine clearance less than 30 mL/min). Before you start using this medication, tell your doctor about your medical history, including if you have kidney problems, bone marrow impairment (e.g., anemia, neutropenia, or thrombocytopenia at baseline), a history of autoimmune hemolytic anemia or a positive Coombs' test, current infections (especially viral illnesses like herpes or chickenpox), gout (history of), or kidney stones (history of). Tell your doctor about all your medications, including prescription, OTC, herbal supplements, and vitamins. There may be a drug interaction between Fludara and other medications. Do not use Fludara in combination with pentostatin (deoxycoformycin) due to the unacceptably high incidence of fatal pulmonary toxicity. Avoid live viral vaccines during and after treatment, as Fludara can decrease your body's resistance and increase the risk of infection from the vaccine itself or from contact with recently vaccinated individuals (e.g., oral polio vaccine). Inform your doctor if you are pregnant or planning to become pregnant before using Fludara. Fludara can cause fetal harm when administered to a pregnant woman.

Females of reproductive potential should use effective contraception during treatment and for 6 months after the final dose. Males are advised not to father a child during treatment and for 95 days after the end of treatment. Inform your doctor if you are breastfeeding or planning to breastfeed before using Fludara. It is unknown if fludarabine passes into breast milk. Do not breastfeed while being treated with Fludara. Do not use this medicine in children without talking to your doctor. The safety and effectiveness of Fludara in children have not been established.

Use your medicine exactly as prescribed by your doctor. Fludara comes as a solution for injection (or a lyophilized powder for reconstitution) and is administered intravenously (into a vein), usually over approximately 30 minutes daily for five consecutive days. Each 5-day course of treatment should commence every 28 days. It is typically given in a hospital or clinic setting under the supervision of a qualified physician experienced in the use of antineoplastic therapy. The dosage may be decreased or delayed based on evidence of hematologic or non-hematologic toxicity, especially in patients with renal impairment. Take Fludara at the same time(s) each day to help you remember. Your doctor may order regular blood tests to monitor your blood cell counts (white blood cells, red blood cells, platelets), kidney function, and other parameters and adjust your dosage as needed. Continue taking Fludara as directed by your doctor until the achievement of maximal response (usually six cycles) or until unacceptable toxicity or disease progression. Fludara is a potent chemotherapy agent and requires careful medical supervision. Store Fludara as instructed by your healthcare provider, typically refrigerated (2-8°C or 36-46°F) for unopened vials. Keep all medicines out of reach of children.

Do I need a prescription to order Fludara?

Yes, a prescription is required from your physician to order Fludara.