Clofarabine (Generic Name)

Other Names: Clolar®

About This Drug

Clofarabine is used to treat relapsed acute leukemia. It is given in the vein.

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Nose bleeds
  • A rash that is itchy or hand-and-foot syndrome may occur. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Low blood pressure.  This can make you feel dizzy or feel that your heart is racing. Your doctor will check your blood pressure as needed.
  • Loose bowel movements (diarrhea) that may last for a few days
  • Changes in your liver function.  Your doctor will check your liver function as needed. 
  • Depression, feeling nervous (anxiety), or other mood changes
  • Headache

Possible Side Effects (Less Common)

  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment and may last up to 48 hours. Medicines are available to stop or lessen these side effects.
  • Decreased appetite (decreased hunger).
  • If you have had shingles (herpes zoster infection) before, it may come back. Symptoms of shingles are burning or shooting pain and tingling or itching, often on one side of the body or face. The pain can be mild or very bad.
  • Swelling of your legs, ankles and/or feet
  • Generalized weakness and discomfort (aches or pains)

Infusion Reactions

Less serious reactions to this drug may happen.  You will be given medicines to help stop or lessen these symptoms.  Your vital signs will be checked during the infusion.  Tell your doctor or nurse right away if you have any of these symptoms any time during the infusion and/or for the first 24 hours after getting this drug.

  • Fever, chills, or shaking chills
  • Feeling dizzy or lightheaded
  • Headache
  • Nausea or throwing up

Treating Side Effects

  • If you are dizzy, get up slowly after sitting or lying.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • Ask your doctor or nurse about medicine that is available to help stop or lessen the loose bowel movements.

Important Information

  • If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.

Food and Drug Interactions

There are no known interactions of clofarabine with food.  This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Easy bleeding or bruising
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised September 2014

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