Cystosine arabinoside AraC

Ara-C is actively transported, and its metabolite ara-CTP is incorporated into DNA, inhibiting DNA polymerases and possibly phospholipid synthesis. Unlike gemcitabine, no further normal nucleotides are added, so that damaged DNA is susceptible to DNA repair.

Ara-C is active in NHL and AML, but not in solid tumours. There is renal excretion of deanimated compound and because of rapid clearance better activity is observed when Ara-C is given by continuous infusion. CSF levels are about half-plasma concentration, Side-effects are:

♦ Myelosuppression

It can also cause 'ara-C syndrome' with fevers, myalgias, rash, keratoconjunctivitis, and arthralgias. Rarely, lung and pancreatic damage occurs. There are significant interactions with many cytotoxics, including:

♦ Hydroxyurea

♦ Cyclophosphamide

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