Fludarabine (Fludara)
General information
Class/mechanism: Purine analog, antimetabolite; fludarabine is converted to the active compound, 2-fluoro-ara-ATP, which inhibits DNA synthesis by inhibiting DNA polymerase alpha, ribonucleotide reductase, and DNA primase. Relatively resistant to deamination by adenosine deaminase. The mechanism of action is not completely characterized and may be multi-faceted.[1][2]
Route: IV, PO Note: Oral fludarabine is no longer available in the US, at this time.
Extravasation: neutral
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is established (work in progress)
Diseases for which it is used
- Acute myeloid leukemia
- Anaplastic large cell lymphoma
- B-cell acute lymphoblastic leukemia
- B-cell lymphoma of mucosa-associated lymphoid tissue
- Chronic lymphocytic leukemia
- Cold agglutinin disease
- Diffuse large B-cell lymphoma
- Hodgkin lymphoma
- Mantle cell lymphoma
- Marginal zone lymphoma
- NK- and T-cell lymphoma
- Peripheral T-cell lymphoma
- Primary mediastinal B-cell lymphoma
- Transformed lymphoma
- Waldenström macroglobulinemia
Diseases for which it was used
Patient drug information
- Fludarabine (Fludara) package insert[1]
- Fludarabine (Fludara) patient drug information (Chemocare)[3]
- Fludarabine (Fludara) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 4/18/1991: Initial FDA approval for the treatment of patients with B-cell chronic lymphocytic leukemia (CLL) who have not responded to or whose disease has progressed during treatment with at least one standard alkylating-agent containing regimen.
Also known as
- Generic names: FAMP, fludarabine phosphate
- Brand names: Beneflur, Fludabine, Fludara, Lymfuda, Oforta
References
- Drugs
- Intravenous medications
- Oral medications
- Neutral
- Human DNA synthesis inhibitors
- Antimetabolites
- Purine analogues
- Acute myeloid leukemia medications
- Anaplastic large cell lymphoma medications
- B-cell acute lymphoblastic leukemia medications
- Chronic lymphocytic leukemia medications
- Cold agglutinin disease medications
- Diffuse large B-cell lymphoma medications
- Follicular lymphoma medications
- Hodgkin lymphoma medications
- MALT lymphoma medications
- Mantle cell lymphoma medications
- Marginal zone lymphoma medications
- NK- and T-cell lymphoma medications
- Peripheral T-cell lymphoma medications
- Primary mediastinal B-cell lymphoma medications
- Transformed lymphoma medications
- Waldenström macroglobulinemia medications
- Multiple myeloma medications (historic)
- Renal cell carcinoma medications (historic)
- FDA approved in 1991
- WHO Essential Cancer Medicine