Fludarabine (Systemic)

Brand Names : Fludara

Before Using This Medicine

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 fludarabine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to fludarabine.

Pregnancy - There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Fludarabine has been shown to cause birth defects in rats and rabbits. In addition, many cancer medicines may cause sterility which could be permanent. Although sterility has not been reported with this medicine, it does occur in animals and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are receiving fludarabine and for at least 6 months after the last dose that you receive. Tell your doctor right away if you think you have become pregnant while receiving fludarabine.

Breast-feeding - It is not known whether fludarabine passes into breast milk. However, because this medicine may cause serious side effects, breast-feeding is not recommended while you are receiving it.

Children - There is no specific information comparing use of fludarabine 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. Although there is no specific information comparing use of fludarabine in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.

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. When receiving fludarabine it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines - Fludarabine may increase the effects of these medicines or radiation therapy on the blood

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) - Fludarabine may raise the amount of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not be as effective in patients receiving fludarabine

Other medical problems - The presence of other medical problems may affect the use of fludarabine. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Immune deficiency condition - may increase the risk of side effects of fludarabine

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of) - Fludarabine may increase levels of uric acid in the body, which can cause gout or kidney stones

• Infection - Fludarabine may decrease your body's ability to fight infection

• Kidney disease - Effects of fludarabine may be increased because of slower removal from the body

• Transfusions - non-irradiated blood transfusion may increase the risk of side effects of fludarabine