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Clofarabine (Clolar®)

About This Drug

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

Possible Side Effects 

  • Increased heart rate
  • Nausea and vomiting (throwing up)
  • Diarrhea (loose bowel movements)
  • Abdominal pain
  • Tiredness
  • Fever, which can be in the setting of decreased white blood cells and put you at an increased risk of infections
  • Bacterial infection in the blood
  • Chills
  • Decreased appetite (decreased hunger)
  • Headache
  • Nosebleed
  • Pain in your arms and/or legs
  • Tiny red spots on the skin, often from low platelets
  • Rash and itching Low blood pressure

Note: Each of the side effects above was reported in 25% or greater of patients treated with clofarabine. Not all possible side effects are included above.

Warnings and Precautions 

  • Severe 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.
  • Abnormal bleeding, which can very rarely be life-threatening – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Severe infections, including viral, bacterial and fungal, which can very rarely be life-threatening.
  • Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work.
  • A syndrome where fluid and protein from your veins can leak into your tissues and cause a decrease in your blood pressure and fluid to accumulate in your tissues and/or lungs.
  • Changes in your liver function and blockage of small veins in the liver, which can cause liver failure and be life-threatening.
  • Changes in your kidney function, which can cause kidney failure.
  • Colitis (swelling (inflammation) in the colon) which can very rarely be life-threatening - symptoms are loose bowel movements (diarrhea) stomach cramping, and sometimes blood in the bowel movements
  • Severe allergic skin reaction. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.

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.

Treating Side Effects 

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • 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).
  • If you have 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.
  • 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
  • To help with decreased appetite, eat small, frequent meals. Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • If you have a nosebleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the 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.
  • Moisturize your skin several times day
  • Avoid sun exposure and apply sunscreen routinely when outdoors
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions 

  • There are no known interactions of clofarabine with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with clofarabine. 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.

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 100.4° F (38° C) or higher
  • Chills
  • Confusion
  • Fast breathing
  • Tiredness that interferes with your daily activities
  • Headache that does not go away
  • Feeling dizzy or lightheaded
  • Wheezing and/or trouble breathing
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Coughing up blood
  • Nosebleed that doesn’t stop bleeding after 10 -15 minutes
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Pain in your abdomen that does not go away
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines Throwing up more than 3 times a day
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Swelling of legs, ankles, or feet
  • Decreased or dark urine
  • A new rash or itching that is not relieved by prescribed medicines
  • Any new tiny red spots on the skin
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures.
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of childbearing potential and men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant.
  • 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: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised June 2019

This patient information was developed by Via Oncology, LLC © 2019. 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.