this may increasingly [30:<25%. a Elimination Metabolism Metabolized to ara-G, principally via O-demethylation by adenosine deaminase; ara-G undergoes further hydrolysis to guanine. a Elimination Route Nelarabine and ara-G are partially eliminated by the kidneys. a Half-life Nelarabine: 0.5 hour. a Ara-G: 3 hours. a Special Populations In pediatric patients, clearance of nelarabine is increased by 30%; ara-G clearance is comparable to that in adults. a Renal impairment may reduce clearance. a In white patients, clearance and volume of distribution of nelarabine increased by 10%; clearance and volume of distribution of ara-G decreased by 15 20% when compared with black patients. a Stability Storage Parenteral Solution 25 C (may be exposed to 15 30 C). a Stable in PVC bags and glass containers at 30 C for up to 8 hours. a Actions Prodrug of the deoxyguanosine analog ara-G, which is subsequently converted to the active 5 -triphosphate, ara-GTP. 1 2 5 Ara-GTP accumulates in leukemic blasts and incorporates into DNA, inducing fragmentation and apoptosis. 1 2 5 Advice to Patients Risk of neurotoxicity; importance of informing clinician immediately if any changes in mental status, signs and symptoms of peripheral neuropathy (e.g., tingling or numbness in extremities, unsteadiness while walking, difficulty with fine motor coordination, increased tripping, weakness when rising from a low chair or climbing stairs), or seizures occur. a Risk of sleepiness; avoid driving or operating machinery. 1 Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as concomitant illnesses. 1 Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed; necessity for clinicians to advise women to avoid pregnancy during therapy; advise pregnant women of risk to the fetus. 1 a Importance of informing patients of other important precautionary information. (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Nelarabine Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral Injection, for IV use 5 mg/mL (250 mg) Arranon GlaxoSmithKline AHFS DI Essentials. Copyright 2017, Selected Revisions May 1, 2007. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 1. GlaxoSmithKline. Arranon (nelarabine) injection prescribing information. Research Triangle Park, NC; 2005 Oct. 2. Anon. Nelarabine (Arranon) for T-cell acute lymphoblastic leukemia. Med Lett Drugs Ther . 2006; 48:14-5. 3. Berg SL, Blaney SM, Devidas M et al. Phase II study of nelarabine (compound 506U78) in children and young adults with refractory T-cell malignancies: a report from the Children s Oncology Group. J Clin Oncol . 2005; 23:3376-82. [PubMed 15908649] 4. Childhood acute lymphoblastic leukemia. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2006 Feb 17. 5. Kisor DF. Nelarabine: a nucleoside analog with efficacy in T-cell and other leukemias. Ann Pharmacother . 2005; 39:1056-63. [PubMed 15870141] 6. Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food and Cosmetic Act as amended by the Orphan Drug Act (P.L. 97-414). Rockville, MD; 2006 Mar 21. From FDA website (). Accessed 2006 Apr 3. 7. GlaxoSmith Kline, Research Triangle Park, NC: Personal communication a. GlaxoSmithKline. Arranon (nelarabine) injection prescribing information. Research Triangle Park, NC; 2006 July. Next Interactions Print this page Add to My Med List More about Arranon (nelarabine) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: antimetabolites Consumer resources Arranon Arranon (Advanced Reading) Professional resources Arranon (FDA) Nelarabine (AHFS Monograph) Related treatment guides Acute Lymphoblastic Leukemia Lymphoma> ] FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer Novartis Pharmaceuticals Corporation Drug Class Antimetabolites Related Drugs Acute Lymphoblastic Leukemia methotrexate , Gleevec , mercaptopurine , imatinib , Adriamycin , doxorubicin , Sprycel , Trexall , dasatinib , Purinethol , Kymriah , More... Lymphoma prednisone , methotrexate , dexamethasone , Decadron , Deltasone , Revlimid , cortisone , Imbruvica , Adriamycin , doxorubicin , Velcade , More... Arranon Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! abruptly
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