Cytarabine into spinal fluid
Read about having the drug cytarabine injected into spinal fluid and the possible side effects. There are sections about
Cytarabine is a type of chemotherapy. You have it as an injection into the fluid around the spinal cord for some types of lymphoma (cancer of the lymph glands).
It kills any lymphoma cells that may be in the fluid surrounding your spine and brain. This treatment is called intrathecal cytarabine.
Doctors may use a type of cytarabine called DepoCyte. Or they may use generic cytarabine.
Cytarabine is sometimes given as an injection into the bloodstream or just under the skin for acute leukaemias (cancers of the blood).
Cytarabine is a clear liquid. An experienced cancer doctor injects it into the fluid around the spinal cord during 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.
Read about having a lumbar puncture.
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.
If you have DepoCyte your doctor prescribes steroid tablets called dexamethasone for you to take. The steroid reduces the side effects.
It is very important that you take the tablets according to the instructions your doctor or pharmacist gives you. You need to take them after a meal, or with milk, as they can irritate your stomach. You should take the right dose, not more or less. Don’t stop taking them without talking to your specialist first.
Read about taking steroids.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with intrathecal cytarabine. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having cytarabine with other medicines.
Tell your doctor, nurse or pharmacist straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of these side effects. They usually happen within the first 5 days.
- Feeling or being sick is usually well controlled with anti sickness medicines – let your doctor or nurse know if you feel sick so they can adjust your medicines
- Confusion – tell your doctor or nurse if you have this
- A high temperature – your nurse will check your temperature regularly
- Headaches – you can have painkillers to help with this
Between 1 and 10 in every 100 people have one or more of these effects
Tell your doctor or nurse if you have any of the following effects.
- Back pain
- Fits (convulsions)
- Neck pain or stiffness
- Pain, numbness or pins and needles
Tell your doctor or nurse straight away if you have these effects.
- Loss of eyesight or other eyesight changes
- Loss of hearing
- Feeling very sleepy (somnolence) – don’t drive or operate machinery
- Loss of ability to move part of the body (paralysis)
- Infection of the covering of the brain and spinal cord (meningitis) causing severe headaches, sudden severe neck stiffness and inability to look at light
Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your nurse will give you a contact number you can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together. Cytarabine may stop some other medicines from working so well.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
You shouldn't have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page doesn't list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at yellowcard.mhra.gov.uk.
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