arranon

Arranon (nelarabine) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Arranon is used to treat T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma.

Arranon may also be used for purposes not listed in this medication guide.

Important information

Arranon may cause serious side effects of the central nervous system, such as problems with balance, coordination, or fine motor skills. These symptoms may not go away even after you stop receiving Arranon. Talk with your doctor if you have concerns about any possible long-term side effects.

Do not use Arranon if you are pregnant. It could harm the unborn baby. You should not breast-feed while you are using nelarabine.

Before you receive Arranon, tell your doctor if you have liver or kidney disease, a nerve disorder, a history of chemotherapy or radiation treatment of your head, neck, or spinal cord.

Arranon can lower blood cells that help your body fight infections and help your blood to clot. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection. Do not receive a "live" vaccine while you are being treated with Arranon. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Before receiving Arranon

You should not receive Arranon if you are allergic to nelarabine.

To make sure you can safely receive Arranon, tell your doctor if you have any of these other conditions:

• liver disease;

• kidney disease;

• a nerve disorder;

• a history of radiation treatment of your head, neck, or spinal cord; or

• a history of cancer medicine injected around your spinal cord.

FDA pregnancy category D. Do not use Arranon if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether nelarabine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using Arranon.

See also: Pregnancy and breastfeeding warnings (in more detail)

How is Arranon given?

Arranon is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Arranon must be given slowly, and the IV infusion can take up to 2 hours to complete.

This medication is usually given every day or every other day for 5 days in a row every 3 weeks. Your treatment schedule may be different. Follow your doctor"s instructions.

Arranon can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your nervous system and kidney function may also need to be tested. Your cancer treatments may be delayed based on the results of these tests. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Arranon injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid?

Nelarabine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using Arranon. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Arranon side effects

Arranon may cause serious side effects of the central nervous system. These symptoms may not go away even after you stop receiving Arranon. Talk with your doctor if you have concerns about any possible long-term side effects.

Get emergency medical help if you have any of these signs of an allergic reaction to Arranon: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• confusion or clumsiness, extreme drowsiness, fainting;

• loss of balance or coordination;

• problems with walking, breathing, speech, swallowing, or eye movement;

• numbness, weakness, or prickly feeling in your fingers or toes;

• problems with buttoning clothes or picking up small items with your fingers;

• loss of movement in any part of your body;

• seizure (convulsions);

• pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• fever, chills, body aches, flu symptoms, sores in your mouth and throat; or

• severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus, chest pain, fast or uneven heart rate.

Less serious Arranon side effects may include:

• cough;

• mild nausea, vomiting, diarrhea, or constipation;

• dizziness, drowsiness, feeling tired;

• joint or muscle pain;

• headache; or

• swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Arranon?

Before receiving Arranon, tell your doctor if you are also using pentostatin.

There may be other drugs that can interact with Arranon. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.