Nelarabine

Other Names: Arranon®

About This Drug

Nelarabine is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding. 
  • Blurry vision
  • Nausea and vomiting (throwing up)
  • Constipation (not able to move bowels)
  • Diarrhea (loose bowel movements)
  • Tiredness
  • Fever
  • Feeling dizzy
  • Headache
  • Extreme tiredness or feeling sleepy
  • This drug can have effects on the nerves which is called neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people. 
  • Cough
  • Trouble breathing

Note: Each of the side effects above was reported in 10% or greater of patients treated with nelarabine. Not all possible side effects are included above.

Warnings and Precautions

  • Seizure. Common symptoms of a seizure can include confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.
  • Severe bone marrow suppression, including fever in the setting of decreased white blood cells, which is a serious condition that can be life-threatening. 
  • Tumor lysis: This drug may act on the cancer cells very quickly. This may affect how your kidneys work. Your doctor will monitor your kidney function.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Talk to your doctor before receiving any vaccinations during your treatment. Some vaccinations are not recommended while receiving nelarabine. 
  • This drug may impair your ability to drive or use machinery. Talk to your doctor and/or your nurse about the necessary precautions to take during this time and let them know if you experience any extreme tiredness or if you are feeling very sleepy. 

Treating Side Effects

  • To decrease the risk of infections, wash your hands regularly. 
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever. 
  • Avoid close contact with people who have a cold, the flu, or other infections. 
  • To minimize your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss. 
  • Be very careful when using knives or tools. 
  • Use an electric shaver instead of a razor. 
  • Manage tiredness by pacing your activities for the day. 
  • Be sure to include periods of rest between energy-draining activities. 
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you are dizzy, get up slowly after sitting or lying. 
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping. 
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea and/or constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories. 
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids. 

Food and Drug Interactions

  • There are no known interactions of nelarabine with food.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions. 
  • The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment.Do not use dietary supplements or alternative diets without your cancer doctor's help. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Seizure
  • Blurred vision or other changes in eyesight
  • Headache that does not go away
  • Confusion or agitation
  • Hallucinations
  • Trouble understanding or speaking
  • Numbness or lack of strength to your arms, legs, face, or body
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • No bowel movement for 3 days or you feel uncomfortable
  • Nausea that stops you from eating or drinking and/or that is not relieved by prescribed medicine
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Numbness tingling in your hands and feet
  • Symptoms of a seizure: confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures.
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures.
  • If you think you are pregnant or may have impregnated your partner. 

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment. Men with female partners of childbearing potential should use a condom during your cancer treatment and for at least 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should not breastfeed during treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised August 2018

This patient information was developed by Via Oncology, LLC © 2018. This information 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.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.