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Drug name: Nelarabine (Arranon®)

About This Drug

Nelarabine is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Tiredness
  • Fever
  • Headache
  • Feeling dizzy
  • Blurry vision
  • Nausea and throwing up (vomiting)
  • Cough
  • Trouble breathing
  • Constipation (not able to move bowels)
  • Loose bowel movements (diarrhea)
  • 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.
  • Extreme tiredness or feeling sleepy
  • This drug can effects on the nerves which is called neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.

Note: Each of the side effects above was reported in 10% or greater of patients treated with nelarabine. Not all possible side effects are included above.

Warnings and Precautions

  • Seizure. Common symptoms of a seizure can include confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.
  • Tumor lysis: This drug may act on the cancer cells very quickly. This may affect how your kidneys work. Your doctor will monitor your kidney function.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you are dizzy, get up slowly after sitting or lying.
  • 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 from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea and/or constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • To minimize your risk of infections, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • To minimize your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Food and Drug Interactions

  • There are no known interactions of nelarabine 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 if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Seizure
  • Blurred vision or other changes in eyesight
  • Headache that does not go away
  • Confusion or agitation
  • Hallucinations
  • Trouble understanding or speaking
  • Numbness or lack of strength to your arms, legs, face, or body
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • No bowel movement for 3 days or you feel uncomfortable
  • Nausea that stops you from eating or drinking and/or that is not relieved by prescribed medicine
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Numbness tingling in your hands and feet
  • Symptoms of a seizure: confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures.
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures.
  • If you think you are pregnant

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. It is recommended that effective methods of birth control should be used by women of child bearing potential while receiving this drug.
  • 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 cause harm to a breast feeding baby.
  • Fertility warning: In men and women both, it is unknown if this drug may affect your ability to have children. This cannot be determined before your therapy. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. Genetic counseling may be available for you to talk about the effects of this drug therapy on future pregnancies.

New June 2017

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