Pyrimidine antimetabolite (specialist)

Cytarabine

Brand names: DepoCyte (intrathecal liposomal)

Adult dose

Dose: Per AML protocol — typical 100–200mg/m²/day continuous IV ×7 days; high-dose 1–3g/m² q12h

Route: IV / SC / Intrathecal

Frequency: Per protocol

Clinical pearls

Backbone of AML induction ("7+3" with anthracycline)
BSH AML guidelines; ESMO
High-dose: prophylactic dexamethasone eye drops, neurological monitoring (cerebellar examination)

Contraindications

Severe hepatic impairment
Severe myelosuppression
Pregnancy/breastfeeding
Hypersensitivity

Side effects

Myelosuppression (severe)
Cytarabine syndrome (fever, myalgia, rash, malaise)
Cerebellar toxicity (high-dose)
Conjunctivitis (high-dose — prevent with steroid eye drops)
Hand-foot syndrome
Hepatotoxicity
Pancreatitis

Interactions

Live vaccines
Methotrexate (synergistic neurotoxicity)
Digoxin (reduced absorption)

Monitoring

FBC
LFTs
Renal
Cerebellar exam (high-dose)
Eye review
Tumour lysis

Reference: BNF; BSH AML guidelines; ESMO; SmPC; https://bnf.nice.org.uk/drugs/cytarabine-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

CNS International Prognostic Index (CNS-IPI) for DLBCL · Lymphoma

Pathways