Fludarabine Phosphate (Generic Name) 

Other Names: Fludara®

About This Drug

Fludarabine phosphate is used to treat cancer. This drug is given intravenously (IV).

Possible Side Effects (More Common) 

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs 13 to 15 days after the drug is given and may be prolonged. This may increase your risk of infection, fatigue, and bleeding.
  • Nausea and vomiting
  • Diarrhea that may last for several days
  • Raised, red rash
  • Decreased appetite
  • Flu-like symptoms: fever, headache, chills, perspiration, muscle and joint aches, and fatigue
  • Difficulty catching your breath
  • Difficulty breathing when lying flat
  • Coughing
  • Muscle weakness
  • Changes in vision, such as blurred or double vision or a decrease in vision

Possible Side Effects (Less Common) 

  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Ankle swelling
  • Chest pain
  • Drowsiness
  • Hearing loss. This effect is rare.
  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.
    • Be careful when cooking, walking, and handling sharp objects and hot liquids.

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
    • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Avoid contact with people who are ill or have infections. You have an increased risk of respiratory illness, such as pneumonia, and other illness and infection that are contagious.
  • Mouth care is very important. Your mouth care should consist of gently brushing with a very soft tooth brush and rinsing your mouth with a mixture of 1/2teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Ask your doctor or nurse about medication to help prevent or lessen nausea, vomiting, and diarrhea.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Be careful when cooking, walking, and handling sharp objects and hot liquids.

Food and Drug Interactions

There are no known interactions of Fludarabine Phosphate with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare.

Tell your doctor or nurse immediately if you have any of the following symptoms during the time you are receiving this drug:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Flushing/itching/rash/hives

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Difficulty catching your breath
  • Rash or itching, dizziness or lightheadedness, or palpitations
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than three times in one day
  • Chest pain
  • Rapid or irregular heartbeat
  • Ankle swelling
  • Difficult or painful urination
  • Urination that is frequent, with small amounts of urine
  • Urgent need to urinate
  • Coughing

 

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Painful mouth or throat that makes it difficult to eat or drink
  • Diarrhea of five or six stools in one day or diarrhea with weakness or lightheadedness
  • Nausea unrelieved by prescribed medication
  • Pain in arms or legs unrelieved by prescribed medication
  • Headache unrelieved by prescribed medication
  • Numbness, tingling, or decreased sensation in fingers and toes
  • Muscle weakness
  • Changes in vision, such as blurred or double vision
  • Changes in hearing
  • Inability to empty all urine in the bladder
  • Persistent loss of appetite or weight loss of five pounds or more in one week
  • Extreme tiredness that interferes with normal activities
  • Rash that is bothersome

Revised December 2011

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com