Fludarabine Pharmacology

Fludarabine

About Fludarabine
Antimetabolite (Purine Antagonist), Organofluoride derivative, Antineoplastic.
Mechanism of Action of Fludarabine
Intracellularly drug is converted into its active form 2-flouro-ara-ATP by the enzyme deoxycytidine kinase through dephosphorylation and phosphorylation steps. This active metabolite inhibits the enzymatic action of DNA polymerase alpha, ribonucleotide reductase and DNA primase. It causes the DNA synthesis inhibition and death of cancer cells.It also inhibits the DNA synthesis of resting cells.
Pharmacokinets of Fludarabine
Absorption- Rapidly absorbed after intravenous administration
Distribution- Widely distributed in the body.19-295 bound to the plasma proteins.
Metabolism- It is metabolized intra cellularly to its active metabolites.2-flouro-ara-ATP is its active metabolite.
Excretion- Excreted via urine
Onset of Action for Fludarabine
Onset of action after administration is 7-12 week
Duration of Action for Fludarabine
N/A
Half Life of Fludarabine
Its elimination half life is 20 hrs
Side Effects of Fludarabine
1. Nausea
2. Vomiting
3. Lowered resistance to infection
4. Bruising or unusual bleeding
5. Anemia
6. Weakness
7. Sore in mouth
8. Taste changes
9. Diarrhea
10. Loss of appetite
11. Visual changes
12. Black, tarry stools
13. Blood in urine or in stool
14. Cough or hoarseness
15. Fever
16. Chills
17. Somnolence
18. Confusion
19. Coma
20. Seizures
21. Ataxia
22. Hallucination
23. Depressive psychosis
24. Dizziness
25. Disorientation
26. Myelo suppression
27. Alopecia
28. Oedema
29. Malaise
30. Fatigue
31. Arrhythmias
32. Heart failure
33. Aneurysm
34. Hemorrhage
35. Supraventricular tachycardia
36. Deep venous thrombosis
37. GI bleeding
38. Renal failure
39. Liver failure
40. Hypocalcaemia
41. Hyperkalemia
42. Hyperglycemia
43. Pneumonia
44. Bronchitis
45. Hypoxia
46. Anaphylaxis

Contra-indications of Fludarabine
1. Hypersensitivity to the drug or to its components
2. Renally impaired patient
Special Precautions while taking Fludarabine
1. Renal insufficiency
2. Pre existing skin cancer
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Fludarabine
1. B-cell chronic lymphocytic leukemia who have not responded to or whose disease has progressed during treatment with at least one standard alkylating agent containing regimen
2. Chronic lymphocytic leukemia
3. Hodgkins disease
4. Malignant lymphoma
5. Hairy-cell leukemia
6. Mycosis fungoides
Interactions for Fludarabine
Pentostatin (deoxycoformycin) : Use of fludarabine in combination with pentostatin is not recommended because of a very high incidence of fatal pulmonary toxicity.
Adenosine uptake inhibitors: The therapeutic efficacy of fludarabine may be reduced by dipyridamole and other adenosine uptake inhibitors.
Typical Dosage for Fludarabine
Intravenous-
Adult-
25mg/metre square over 30 minutes for 5 consecutive days every 28 days
For Chronic lymphocytic leukemia:18-30mg/metre square over 30 minutes for 5 consecutive days every 28 days
Schedule of Fludarabine
N/A
Storage Requirements for Fludarabine
Store under refrigeration (2-8 degree Celsius)
Effects of Missed Dosage of Fludarabine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Fludarabine
Discontinue the therapy and give symptomatic and supportive treatment.

Home Delivery for Fludarabine in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including fludarabine.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for fludarabine and other medicines and health products. Home delivery services for fludarabine may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take fludarabine only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for fludarabine before they complete the sale. You can get this information while placing the order for fludarabine with the pharmacy.

Fludarabine is a generic medicine name and there are several brands available for it. Some of the brands for fludarabine might be better known than fludarabine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have fludarabine in stock, you can ask for one of the branded alternatives for fludarabine.