It's normal to feel overwhelmed and anxious when you or a loved one is diagnosed with cancer, especially acute leukemia. At times like these, your doctor will talk to you about various treatments. One of those treatments is a vaccine called Clofarabine. Its brand name is Clolar. Today, let's talk about this drug, what it does, and what you need to be aware of.
What kind of medicine is this Clofarabine?
Simply put, clofarabine is a drug that fights cancer cells. This drug is used, in particular, in cases of acute leukemia. Cancer cells in our body divide and grow very quickly. This drug slows down the growth of those cancer cells and controls their spread . This is a part of cancer treatment (chemotherapy).
Things you need to tell your doctor before starting this medication
In order for your medical team to provide you with the best and safest treatment, it is essential that they know the full details of your health condition. Therefore, before starting treatment with clofarabine, be sure to tell your doctor if you have any of the following conditions:
- If you have a bleeding disorder or a condition where your blood does not clot easily.
- If you currently have an infection such as fever, cough, or cold.
- If you have any kidney disease .
- If you have ever had an allergic reaction to clofarabine or any other medicine, food, or dye .
- If you are pregnant or planning to become pregnant soon .
- If you are a breastfeeding mother .
Don't hide this information from the doctor, because all this information is very important for your safety.
How will this medicine be given to you?
This is not a pill or syrup that you can take home. It is only given in a hospital or clinic. It is given as an injection into a vein by a trained doctor or nurse.
Doctors sometimes prescribe this medicine to children as young as one year old, but they do so with great care and special precautions.
What to do if the medication dose is increased?
Since this is given in a hospital, the chances of a missed dose are very low. However, if you feel that you have overdosed in any way or if you experience any symptoms, inform the medical team immediately. In an emergency, you can call the National Poisons Information Centre at the National Hospital in Colombo . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I miss a dose of medication?
It is very important to take this medication on the scheduled days and at the scheduled times. If you are unable to go to the hospital to receive your dose on the scheduled day, do not skip it. Call your doctor immediately and tell them. They will tell you what to do next.
Other medications that may interact with this medicine
It is very important to tell your doctor about all the medications you are taking, not just those prescribed by your doctor, but also over-the-counter pain relievers, vitamins, herbal remedies, and anything else you are using. Some medications can interact with clofarabine, causing unwanted side effects or changing how the medication works.
Below are just a few examples. This list is not exhaustive.
| Drug category | Examples |
|---|---|
| Painkillers and fever reducers | NSAIDs such as Acetaminophen, Aspirin, Ibuprofen, Naproxen |
| Medications for heart disease and high blood pressure | Amiodarone, Methyldopa, various diuretics |
| Cholesterol-lowering medications | Atorvastatin, Simvastatin |
| Medicines for various infections (antibiotics/antifungals) | Amphotericin B, Fluconazole, Ketoconazole, Acyclovir, Amoxicillin, Gentamicin, Tetracycline, Vancomycin, Rifampin |
| Medicine for epilepsy/seizures | Carbamazepine, Phenytoin, Valproic acid |
| Other anticancer and immune-suppressing drugs | Cisplatin, Cyclosporine, Methotrexate |
Things you should be careful about while taking the medicine
The medical team will monitor you very closely while you are taking this medication, but it is also important for you to pay attention to your body.
- Blood tests and medical monitoring: During this treatment, you will need to have regular blood tests to check your blood cell count, kidney and liver function. Do not skip these.
- Bleeding risk: This medicine can reduce the number of cells in your body that help your blood clot (platelets). This can make it harder for even a minor cut to stop bleeding. Tell your doctor right away if you notice any unusual bruising, purple spots, bleeding gums, or nosebleeds .
- Risk of infection: This medicine lowers your body's immunity, so you may easily get infections. If you experience symptoms such as fever, chills, sore throat, or cough , do not self-medicate and call your doctor immediately. Minimize your visits to places where people are sick.
- Serious skin reactions: Sometimes, even weeks after starting the medication, serious skin reactions can occur. If you notice anything like red or purple blisters on your skin along with a fever, skin peeling, or sores inside your mouth, don't ignore it. Seek medical advice immediately.
- Pregnancy and breastfeeding: This medicine can cause serious birth defects in the baby if taken during pregnancy . Therefore, you should avoid becoming pregnant during treatment and for 6 months after stopping treatment. Also, avoid breastfeeding during treatment and for 2 weeks after stopping treatment.
- Fertility: This medicine may affect fertility in both men and women. This means that it may affect your ability to have children in the future. If you have any concerns about this, talk to your doctor before starting treatment.
Side effects that may occur due to this medicine
Like any medicine, clofarabine can cause side effects. Not everybody gets them. However, it is important to be aware of the possible ones.
| Side effect | What you feel/see |
|---|---|
| Side effects that you should report to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Abnormal bleeding | Black or bloody stools, vomit that looks like coffee grounds, red/dark brown urine, red/purple spots on the skin. |
| Capillary Leak Syndrome | Pain in the stomach or muscles, extreme fatigue, fainting, decreased urine output, swelling of the ankles, hands, and feet, and difficulty breathing. |
| Symptoms of infection | Fever, chills, cough, sore throat, non-healing wounds. |
| Kidney injury | Decreased urine output, swelling of the ankles, hands, and feet. |
| Liver injury | Pain in the upper right side of the stomach, loss of appetite, nausea, yellowing of the skin or eyes, dark yellow/brown urine. |
| Tumor Lysis Syndrome (TLS) | Nausea, vomiting, diarrhea, decreased urination, irregular heartbeat, muscle twitching, confusion. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Headache | - |
| Appetite | - |
| Nausea and vomiting | - |
| Pain in the hands and feet | - |
Take-Home Message
- Clofarabine is a powerful drug that is given intravenously in the hospital to treat leukemia.
- Before starting treatment, tell your doctor completely about all other medications, vitamins, and allergies you are taking.
- During treatment, if you notice any signs of unusual bleeding, infection (fever, cough), or severe skin changes, seek medical advice immediately.
- Avoid becoming pregnant while taking this medicine and for 6 months after stopping. Also avoid breastfeeding.
- Talk openly with your doctor or medical team about any questions, fears, or concerns you may have. They are there to help you.
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