Clofarabine Injection (patient information)

# Why this medication is prescribed
Clofarabine is used to treat acute lymphoblastic leukemia (ALL; a type of cancer of the white blood cells) in children and young adults 1-21 years old who have already received at least two other treatments. Clofarabine is in a class of medications called purine nucleoside antimetabolites. It works by killing existing cancer cells and limiting the development of new cancer cells.

# How this medication should be used
Clofarabine comes as a solution to be injected into a vein. Clofarabine is administered by a doctor or nurse. It is usually given once a day for 5 days in a row. This dosing cycle may be repeated once every 2-6 weeks, depending on your response to the medication.
It will take at least 2 hours for you to receive each dose of clofarabine. Tell your doctor or other healthcare provider right away if you feel anxious or restless while you are receiving the medication.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before using clofarabine:
- tell your doctor and pharmacist if you are allergic to clofarabine or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention medications for high blood pressure and heart disease. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had kidney or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. Clofarabine may harm the fetus. You should use birth control to prevent pregnancy during your treatment with clofarabine. Talk to your doctor about types of birth control that will work for you. If you become pregnant while using clofarabine, call your doctor.
- tell your doctor if you are breast-feeding. You should not breastfeed during your treatment with clofarabine.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving clofarabine.
- you should know that clofarabine may cause a skin condition called hand-foot syndrome. If you develop this condition, you may experience tingling of the hands and feet, and then reddening, dryness, and flaking of the skin on the hands and feet. If this happens, ask your doctor to recommend a lotion that you can apply to these areas. You will need to apply the lotion lightly and avoid rubbing the areas forcefully. Your doctor may also prescribe medication to relieve these symptoms.

# Special dietary instructions
Drink plenty of fluids every day during your treatment with clofarabine, especially if you vomit or have diarrhea.

# Side effects

## Minor side effects
Clofarabine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nausea
- vomiting
- stomach pain
- diarrhea
- constipation
- loss of appetite
- weight loss
- swelling of the inside of the mouth and nose
- painful white patches in the mouth
- headache
- anxiety
- depression
- irritability
- pain in the back, joints, arms, or legs
- drowsiness
- dry, itchy, or irritated skin
- flushing

## Severe side effects
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- fast heartbeat
- fast breathing
- shortness of breath
- dizziness
- lightheadedness
- fainting
- decreased urination
- sore throat, cough, fever, chills, and other signs of infection
- pale skin
- excessive tiredness
- weakness
- confusion
- unusual bruising or bleeding
- nosebleed
- bleeding gums
- blood in urine
- small red or purple spots under the skin
- yellowing of the skin or eyes
- itching
- red, warm, swollen, tender skin
- uncontrollable shaking of a part of the body
Clofarabine may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

# Storage conditions needed for this medication
This medication will be stored in the hospital.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- yellowing of the skin or eyes
- vomiting
- rash

# Other information
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to clofarabine.

# Brand names
- Clolar