Dangerous Drug: Fludarabine Phosphate(floo dar’ a been)
PREGNANCY CATEGORY D
Drug Classes
Antimetabolite
Antineoplastic
Therapeutic Actions
Inhibits DNA polymerase alpha, ribonucleotide reductase and DNA primase, which inhibits DNA synthesis and prevents cell replication.
Indications
Chronic lymphocytic leukemia (CLL); unresponsive B-cell CLL or no progress during treatment with at least one standard regimen that contains an alkylating drug
Contraindications and Cautions
Contraindicated with allergy to fludarabine or any component, lactation, pregnancy, severe bone marrow depression.
Use cautiously with renal impairment.
Available Forms
Injection—25 mg/mL, 50 mg/vial
Dosages
Adults
40 mg/m2 PO or 25 mg/m2 IV over 30 min for 5 consecutive days. Begin each 5-day course every 28 days. Recommendation is to use three additional cycles after a maximal response is achieved, then to discontinue drug.
Patients with renal impairment
CrCl of 30–70 mL/min, reduce dosage by 20%; CrCl of less than 30 mL/min, do not administer IV form, and reduce dose by 50% for oral doses.
Pharmacokinetics
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