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Cytarabine into spinal fluid

Find out what cytarabine injected into the spinal fluid (intrathecal) is, how you have it and other important information about having this drug.

Cytarabine is a chemotherapy drug. Doctors may use a type of cytarabine called DepoCyte. Or they may use generic cytarabine.

It is a treatment for some types of lymphoma (cancer of the lymph glands).

How it works

This drug is a type of chemotherapy drug called an anti metabolite.

Anti metabolites are similar to normal body molecules but they are slightly different in structure. They kill cancer cells by stopping them making and repairing DNA that they need to grow and multiply.

How you have it

Cytarabine is a clear liquid. An experienced cancer doctor injects it into the fluid around the spinal cord during a lumbar puncture. This treatment is also called intrathecal cytarabine.

If you have DepoCyte your doctor prescribes steroid tablets called dexamethasone for you to take. The steroid reduces the side effects. You need to take them after a meal, or with milk, as they can irritate your stomach.

Intrathecal injection

You have an intrathecal injection of cytarabine the same way you have a lumbar puncture. You lie on your side. Your doctor gives you a small injection to numb an area in your back. They then inject the cytarabine between 2 of your spinal bones into the spinal fluid. It takes from 1 to 5 minutes. Afterwards you need to lie flat for an hour.

Diagram showing how you have a lumbar puncture

Taking tablets

You must take tablets according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

If you have DepoCyte treatment you usually have it every 2 weeks for 5 doses. After that you have treatment once a month for 4 months.

If you have generic cytarabine you may have the treatment from twice a week to once a month. The number of treatments may vary. Your doctor will tell you how often you need treatment.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception and for how long you should use it before starting treatment.

Loss of fertility

We don’t know how this treatment might affect fertility. You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Some men might be able to store sperm before starting treatment. Some women might be able to store eggs or embryos before treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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