Clofarabine, Injection kloh-FAR-a-been

What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: clofarabine, injection; Clolar

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to treat children 1 to 21 years old with relapsed acute lymphoblastic leukemia. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a blood disorder or bleeding problems
• a weakened immune system from diseases such as HIV/AIDS or from other chemotherapy, radiation therapy, or steroid medicine
• liver or kidney disease

Males should use effective birth control. This medicine may affect sperm and lead to birth defects.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I use it?

This medicine is given by your healthcare provider. The infusion is given over 2 hours daily for 5 days in a row. Treatment cycles are repeated every 2 to 6 weeks. Your child will be monitored closely while receiving this medicine. Keep all appointments for treatments and tests.

What should I watch out for?

Your child will need to have blood tests regularly. Keep all appointments for these tests.

Your child may get infections more easily when receiving this medicine. Stay away from people with colds, flu, or other infections. Also, your child should not have any vaccines without getting your healthcare provider's approval first.

Report any unusual bleeding or bruising, dizziness, lightheadedness, fainting spells, or decreased urine output to your healthcare provider.

This medicine may make your child's mouth sore. Use a soft bristle brush or mouth swab to brush teeth.

If your child needs emergency care, surgery, or dental work, tell the healthcare provider or dentist your child is receiving this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to contact your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reactions (hives, itching, rash, tightness in your chest, trouble breathing); seizures.

Serious (report these to your healthcare provider right away): Severe nausea and vomiting; inflammation or sores near the mouth, eyes, or rectum; sore, red eyes; unusual bleeding or bruising; fever; chills; sore throat; dizziness; lightheadedness; fainting spells; decreased urine output; unusual tiredness or weakness; fast heartbeat; trouble breathing; yellowing of skin or eyes.

Other: Loss of appetite, diarrhea, vomiting, irritation where the shot was given, headache, stomach cramps, nervousness, dry or red skin.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alpha blockers such as doxazosin (Cardura) and prazosin (Minipress)
• angiotensin receptor II blockers such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
• calcium channel blockers such as diltiazem (Cardizem, felodipine, isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera-HS, Isoptin SR, Verelan, Tiazac)
• digoxin (Lanoxin)
• diuretics such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide, spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• natural remedies such as echinacea, garlic, ginkgo biloba, and ginseng
• medicines to treat or prevent blood clots such as abciximab (ReoPro), argatroban, bivalirudin (Angiomax), clopidogrel (Plavix), dipyridamole (Persantine), lepirudin (Refludan), pentosan polysulfate sodium (Elmiron), tirofiban (Aggrastat), and warfarin (Coumadin)
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.