Cytarine Dosage/Direction for Use

RECOMMENDED DOSE AND MODE OF ADMINISTRATION: Cytarabine 100 mg/ml injection is a ready to use injection and can be administered by intravenous and subcutaneous routes.
Cytarabine 100 mg/ml Injection should not be administered by the intrathecal route.
Remission Induction: Adult: Continuous Dosing: The usual dose in leukaemia, is 2 mg/kg by rapid intravenous injection daily for ten days. If after ten days neither therapeutic response nor toxicity has been observed, the dose may be increased to 4 mg/kg until a therapeutic response or toxicity is evident. Daily blood counts should be taken. Almost all patients can be carried to toxicity with these doses.
Alternatively, 0.5 to 1 mg/kg may be infused daily in 1-24 hours for ten days, and then at a rate of 2 mg/kg/day until toxicity is observed. Continue to toxicity or until remission occurs. Results from one-hour infusions have been satisfactory in the majority of patients.
For the induction of remission in acute leukaemias many dosage regimens have been used: 100 mg/m² twice daily by rapid intravenous injection, or 100 mg/m² daily by continuous intravenous infusion, both for 7 days, are used in combination regimens for acute myeloid leukaemia.
Intermittent dosing: Cytarabine may be given as intermittent intravenous doses of 3-5 mg/kg daily, for five consecutive days. This course of treatment can be repeated after an interval of 2 to 9 days and repeated until the therapeutic response or toxicity is exhibited.
Evidence of bone marrow improvement has been reported to occur 7-64 days after the beginning of therapy. In general, if a patient shows neither remission nor toxicity after a trial period, then cautiously administered higher doses can be administered. Generally patients tolerate higher doses given by rapid intravenous injection rather than slow infusion.
As a single agent for induction of remission in patients with acute leukaemia, cytarabine has been given in doses of 200 mg/m² by a continuous intravenous infusion for five days at approximately two week intervals.
Dilutions of CYTARINE (Cytarabine) should be made in Glucose 5% or Sodium Chloride 0.9% Intravenous Infusions to concentrations as low as 0.1 mg/mL. In order to reduce any microbiological hazard it is recommended that dilution should be effected immediately prior to use and infusion commenced as soon as practicable after preparation of the admixture. Infusion should be completed within 24 hours of preparation and any residue discarded. Any storage should be between 2-8°C, protected from light.
Maintenance therapy: To remission, doses of 1 mg/kg may be given intravenously or subcutaneously, once or twice weekly.
Children: Children appear to tolerate higher doses of cytarabine than adults, and where the range of doses is given, children should receive the higher dose.
Elderly: No data is available to suggest that a change in dose is necessary in the elderly. However, the elderly patient is more susceptible to toxic reactions and therefore particular attention should be paid to drug induced leucopenia, thrombocytopenia and anaemia.