Fludarabine (Fludara®)

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 About This Drug

Fludarabine phosphate 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.
  • Fever
  • Chills
  • Infection
  • Nausea and vomiting (throwing up)
  • Decreased appetite (decreased hunger)
  • Tiredness and weakness
  • General discomfort, a feeling of being unwell
  • Cough

Note: Not all possible side effects are included above.

Warnings and Precautions 

  • Severe bone marrow depression which can be life-threatening.
  • Severe diarrhea, vomiting, decreased appetite and mouth sores.
  • Severe infections, including viral, bacterial and fungal, which can be life-threatening.
  • 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), have 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, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Autoimmune problems such as a breakdown of your red blood cells and/or platelets, which can cause anemia (decreased red blood cells) and increases your risk of bleeding.
  • Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work.
  • 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.
  • Inflammation (swelling) of the lungs. You may have a dry cough or trouble breathing.

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 fludarabine.
  • This drug may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel dizzy, or very sleepy.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease 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 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.
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • 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 stop or lessen nausea.
  • 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 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.

Food and Drug Interactions

  • There are no known interactions of fludarabine 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.

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
  • Feeling dizzy or lightheaded
  • Confusion and/or agitation
  • Symptoms of a seizure such as 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. If you or your family member suspects you are having a seizure, call 911 right away.
  • Hallucinations
  • Trouble understanding or speaking
  • blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Wheezing or trouble breathing
  • Pain in your chest
  • Cough
  • Easy bleeding or bruising
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Tiredness that interferes with your daily activities
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping numbness and/or tingling, seizures 
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • If you think you may be pregnant or have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can 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 and for 6 months after 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 talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: 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 March 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.