Live Vaccines
Contraindicated
Database
Immunosuppression — disseminated infection
Avoid live vaccines
Source: Kimi deep-research + Cla
Drug reference
Cytarabine
Antimetabolite (pyrimidine nucleoside analogue) · Antineoplastic
START
AML induction 100–200 mg/m²/day CIV ×7 days with anthracycline; high-dose per protocol
TYPICAL MAX
High-dose regimen-defined (e.g. 3 g/m² q12h)
STOP IF
Cerebellar/neurologic toxicity (high-dose — stop), severe non-haematologic toxicity
WATCH
CBC, neuro/cerebellar exam before each high-dose, corticosteroid eye drops (high-dose), renal/hepatic function
CDSCO approvedSchedule HATC L01BC01
KDIGO 2024 + manufacturer label
- ONSET
- 8min · absorption onset
- PEAK
- 30min · plasma Cmax (rapid)
- t½
- 2h · terminal t½
- DURATION
- 1w · 7-day infusion
EXCRETION
Deamination to ara-U; ~80% renal
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Avoid — teratogenic, especially first trimester; effective contraception
FDA category + note
Top interactionssee all 12 →
- Live VaccinesContraindicatedDatabaseKimi deep-research + Cla
- AdalimumabSevereDatabaseDDInter
- BaricitinibSevereDatabaseDDInter
- BexaroteneSevereDatabaseDDInter
Available in India
36 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Intracellularly phosphorylated to ara-CTP, which inhibits DNA polymerase and is incorporated into DNA causing chain termination; S-phase specific. Antileukaemic mainstay.
Indications
Acute myeloid leukaemia (induction and consolidation)Acute lymphoblastic leukaemia; lymphomasMeningeal leukaemia/lymphoma (intrathecal)Blast crisis of CML
Dosing
- Adult
- Standard-dose 100–200 mg/m²/day continuous IV ×7 days (induction with anthracycline). High-dose 1–3 g/m² q12h (consolidation). Intrathecal 30–100 mg per dose.
- Pediatric
- Protocol-specific (specialist).
- Renal adjustment
- High-dose: reduce in renal impairment (neurotoxicity risk).
- Hepatic adjustment
- Reduce dose with hepatic dysfunction (monitor).
- Geriatric
- High-dose cerebellar toxicity markedly increased — reduce dose, neuro checks.
- Max dose
- High-dose regimen-defined (e.g. 3 g/m² q12h)
Pharmacokinetics
Onset
Counts nadir ~day 7–14
Peak effect
Plasma minutes (rapid deamination)
Duration
Cycle/infusion-based
Half-life
Initial ~10 min; terminal ~1–3 h
Bioavailability
Poor oral (deaminated) — IV/SC/IT
Protein binding
~13%
Metabolism
Deamination (cytidine deaminase) to inactive ara-U (liver, GI, blood)
Excretion
Renal (~80% as ara-U)
Contraindications
- Severe hypersensitivity to cytarabine
- Pre-existing severe bone marrow suppression (relative; disease-dependent)
Side effects
Common
Myelosuppression (dose-limiting)Nausea/vomiting, mucositis, diarrhoeaFever (cytarabine syndrome)Conjunctivitis (high-dose)
Serious
- Severe myelosuppression/infection/bleeding
- Cerebellar/cerebral neurotoxicity (high-dose, elderly, renal impairment)
- Cytarabine syndrome (fever, myalgia, rash)
- Pulmonary oedema/ARDS; pancreatitis; severe GI ulceration
- Chemical arachnoiditis (intrathecal)
Pregnancy & lactation
Pregnancy
Avoid — teratogenic, especially first trimester; effective contraception
Lactation
Contraindicated — discontinue breastfeeding
Drug interactions
Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Baricitinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bexarotene
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Certolizumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cladribine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Deferiprone
Severe
Database
Clinical effect not specified
Source: DDInter
Etanercept
Severe
Database
Clinical effect not specified
Source: DDInter
Fingolimod
Severe
Database
Clinical effect not specified
Source: DDInter
Golimumab
Severe
Database
Clinical effect not specified
Source: DDInter
Infliximab
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Cytarabine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19