Fludarabine

Fludarabine
Clinical data

Trade names	Fludara, others
AHFS/Drugs.com	Monograph
MedlinePlus	a692003
Pregnancy category	D
Routes of administration	intravenous, by mouth
ATC code	L01BB05 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) UK: POM (Prescription only)
Pharmacokinetic data
Bioavailability	55%
Protein binding	19 to 29%
Biological half-life	20 hours
Excretion	kidney
Identifiers
IUPAC name [(2R,3R,4S,5R)-5-(6-amino-2-fluoro-purin-9-yl)- 3,4-dihydroxy-oxolan-2-yl]methoxyphosphonic acid
CAS Number	21679-14-1^N
PubChem (CID)	657237
IUPHAR/BPS	4802
DrugBank	DB01073^Y
ChemSpider	571392^Y
UNII	1X9VK9O1SC^N
KEGG	D01907^Y
ChEBI	CHEBI:63599^N
ChEMBL	CHEMBL1568^Y
ECHA InfoCard	100.123.703
Chemical and physical data
Formula	C₁₀H₁₃FN₅O₇P
Molar mass	365.212 g/mol
3D model (Jmol)	Interactive image
SMILES Fc1nc(c2ncn(c2n1)[C@@H]3O[C@@H]([C@@H](O)[C@@H]3O)CO)N
InChI InChI=1S/C10H12FN5O4/c11-10-14-7(12)4-8(15-10)16(2-13-4)9-6(19)5(18)3(1-17)20-9/h2-3,5-6,9,17-19H,1H2,(H2,12,14,15)/t3-,5-,6+,9-/m1/s1^Y Key:HBUBKKRHXORPQB-FJFJXFQQSA-N^Y
^NY (what is this?)

Fludarabine, sold under the brand name Fludara among others, is a chemotherapy medication used in the treatment of leukemia and lymphoma. This include chronic lymphocytic leukemia, non-Hodgkin's lymphoma, acute myeloid leukemia, and acute lymphocytic leukemia. It is given by injection into a vein or by mouth.

Common side effects include nausea, diarrhea, fever, rash, shortness of breath, numbness, vision changes, and feeling tired. Severe side effects include brain dysfunction, low blood cell counts, and lung inflammation. Use in pregnancy will likely result in harm to the baby. Fludarabine is in the purine analog family of medications and works by interfering with the duplication of DNA.

Fludarabine was approved for medical use in the United States in 1991. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about 54.00 USD per 50 mg vial. In the United Kingdom it costs about 155.00 pounds per 50 mg vial.

Fludarabine is highly effective in the treatment of chronic lymphocytic leukemia, producing higher response rates than alkylating agents such as chlorambucil alone. Fludarabine is used in various combinations with cyclophosphamide, mitoxantrone, dexamethasone and rituximab in the treatment of indolent non-Hodgkins lymphomas. As part of the FLAG regimen, fludarabine is used together with cytarabine and granulocyte colony-stimulating factor in the treatment of acute myeloid leukaemia. Because of its immunosuppressive effects, fludarabine is also used in some conditioning regimens prior to allogeneic stem cell transplant.

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