HEALTHY LIFESTYLE




Fludarabine phosphate
Fludarabine phosphate.JPG

Fludarabine phosphate

CLINICAL USE

B-cell chronic lymphocytic leukaemia

DOSE IN NORMAL RENAL FUNCTION

IV: 25 mg/m2 daily for 5 days, repeated every 28 daysOral: 40 mg/m2 for 5 days every 28 days

PHARMACOKINETICS

  • Molecular weight                           :365.2
  • %Protein binding                           :19–29
  • %Excreted unchanged in urine     : 40–60
  • Volume of distribution (L/kg)       :0.8–4
  • half-life – normal/ESRD (hrs)      :20/24

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–70 50–75% of normal dose10–30 50–75% of normal dose. Use with care
  • <10           : 50% of normal dose. Use with care

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Unknown dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR=10–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosisCytotoxics: increased pulmonary toxicity with pentostatin (unacceptably high incidence of fatalities); increases intracellular concentration of cytarabine

    ADMINISTRATION

    Reconstition

    Reconstitute each vial with 2 mL of water to give a concentration of 25 mg/mL

    Route

    IV, oral

    Rate of Administration

    Infusion should be administered over 30 minutes

    Comments

    IV bolus in 10 mL of sodium chloride 0.9%

    IV infusion

    in 100 mL of sodium chloride 0.9%

    OTHER INFORMATION

    Rapidly dephosphorylated in plasma to (2-F-9-ß-D-arabinofuranosyladenine) 2-F-ara-ATP, which is necessary for cellular uptakeApproximately 60% of an administered dose is excreted in the urine within 24 hrsAdminister up to achievement of clinical response (usually 6 cycles) then discontinuePatients with renal failure (GFR=17– 41 mL/min/m2) receiving 20% of dose had a similar AUC as patients with normal renal function receiving the full doseFludarabine phosphate.
  • other drugs