Nelarabine solution for injection

What is this medicine?

NELARABINE (nel AR a been) is a chemotherapy drug. It interferes with the growth of cancer cells. It is used to treat T-cell lymphoblastic leukemias and lymphomas.

How should I use this medicine?

This drug is given as an infusion into a vein. It is administered in a hospital or clinic by a specially trained health care professional.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 1 year of age for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• low blood counts - this medicine may decrease the number of white blood cells, red blood cells, and platelets. You may be at increased risk for infections and bleeding.

• muscle pain or weakness

• pain, tingling, numbness in the hands or feet

• problems with balance, climbing stairs, walking

• problems with buttoning clothes, writing, other fine motor skills

• seizures

• signs of infection - fever or chills, cough, sore throat, pain, or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, or nosebleeds

• signs of decreased red blood cells - unusually weak or tired, fainting spells, or lightheadedness

• sudden numbness or weakness of the face, arm, or leg

• tiredness

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• constipation

• diarrhea

• headache

• loss of appetite

• nausea, vomiting

What may interact with this medicine?

This medicine may interact with the following medication:

• pentostatin

What if I miss a dose?

It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment.

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• chemotherapy or radiation of the brain and/or spine

• kidney disease

• nervous system problems

• recently received or scheduled to receive a vaccine

• an unusual or allergic reaction to nelarabine, other chemotherapy, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even through you feel ill unless your doctor tells you to stop.

You may need blood work done while you are taking this medicine.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 3 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.