In the U.S.—

• Antineoplastic

Liposomal cytarabine (LIP-oh-som-al sye-TARE-a-been) belongs to the group of medicines known as antineoplastics. It is used to treat cancer of the lymph system that has spread to the brain.

Liposomal cytarabine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other effects may also occur. Some of these may be serious and must be reported to your doctor. Some effects may occur after treatment with liposomal cytarabine has been stopped.

Before you begin treatment with liposomal cytarabine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Liposomal cytarabine is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For liposomal cytarabine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to cytarabine or liposomal cytarabine. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Liposomal cytarabine has not been studied in humans, but has been found to cause birth defects or other problems in rats and mice.

Be sure that you have discussed this with your doctor before starting treatment with this medicine. It is best to use birth control while you are receiving liposomal cytarabine. Also, tell your doctor right away if you think you have become pregnant during treatment.

Breast-feeding—It is not known whether liposomal cytarabine passes into the breast milk. However, liposomal cytarabine is not recommended during breast-feeding because it may cause unwanted effects in nursing babies.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of liposomal cytarabine in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of liposomal cytarabine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your doctor and pharmacist if your are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Active meningitis—Use is not recommended

• Blockage to cerebrospinal fluid flow— Increased risk of neurotoxicity

This medicine often causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing—

Dosing—The dose of liposomal cytarabine will be different for different patients. The dose that is used may depend on a number of things, including the patient's weight and whether or not other medicines are also being taken. If you have any questions about the proper dose of cytarabine, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Back pain;  fever;  headache;  nausea;  neck pain or rigidity;  sleepiness;  vomiting;  weakness 
  
  

• Less common
  • Black, tarry stools;  blood in urine or stools;  chills;  cough or hoarseness;  lower back or side pain;  painful or difficult urination;  pinpoint red spots on skin;  sore throat;  swelling of fingers, hands, arms, lower legs, or feet;  unusual bleeding or bruising 
  
  

• Rare
  • Fast or irregular breathing;  puffiness or swelling around the face;  shortness of breath ;  sudden, severe decrease in blood pressure;  unusual tiredness 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Less common
  • Constipation;  urinary incontinence 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.