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Dose Dependent Neurologic Toxicities.

Applies to the following strengths: 10 mg; 25 mg/mL; 50 mg25 mg/m2 IV over 30 minutes for 5 days every 28 days; following a maximal tumor response, 3 additional cycles are recommendedThis drug may cause/enhance toxicity in advanced age, renal insufficiency, and bone marrow impairment. azasan-imuran-azathioprine-343191

The dose may be increased, beginning at 6 to 8 weeks and thereafter by steps at 4-week intervals, if there are no serious toxicities and if initial response is unsatisfactory. 2002 2010

Dose levels approximately 4 times greater (96 mg/m²/day for 5 to 7 days) than that recommended for CLL (25 mg/m²/day for 5 days) were associated with a syndrome characterized by delayed blindness, coma … Contact the applicable plan and formulary information changes. 1107742-overview provider for the most current information.The recipient will receive more details and instructions to access this offer.By clicking send, you acknowledge that you have permission to email the recipient with this information.The recipient will receive more details and instructions to access this offer.By clicking send, you acknowledge that you have permission to email the recipient with this information.

3-5 mg/kg/day IV/PO initially on day of transplant; 1 to 3 days prior to transplantation also reported (rare) 1 mg/kg/day IV/PO initially in single daily dose or divided q12hr; after 6-8 weeks, increase by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reachedInduction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines)2 mg/kg/day PO with or without low-dose corticosteroids 1-2 mg/kg PO once daily to maximum daily dose of 150 mg for at least 3-6 months before typical response is observed1 mg/kg/day IV/PO initially in single daily dose or divided q12hr; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached3-5 mg/kg/day IV/PO initially on day of transplant or 3 days before transplant (rare) Induction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines)>12 years: 2 mg/kg/day PO with or without low-dose corticosteroidsSweet syndrome (acute febrile neutrophilic dermatosis)Chronic immunosuppression with this purine antimetabolite increases neoplasia risk, mutagenic risk, and hematologic toxicitiesReported malignancies include posttransplant lymphoma and hepatosplenic T-cell lymphoma (HSTCL) in patients with inflammatory bowel diseasePrescribing physicians should be familiar with mutagenic potential and with possible hematologic toxicitiesRheumatoid arthritis: Patients previously treated with alkylating agentsIncreased risk of infection and hepatotoxicity; monitor liver function periodically; hepatic sinudoidal obstruction syndrome reported; discontinue therapy if suspectedCases of JC virus-associated infection resulting in progressive multifocal leukoencephalopathy (PML), sometimes fatal, reported in patients treated with immunosuppressants, including azathioprineSevere leukopenia, thrombocytopenia, anemias including macrocytic anemia, and/or pancytopenia may occur; severe bone marrow suppression may also occur; patients with or nucleotide diphosphatase (NUDT15) deficiency may be at an increased risk of myelotoxicity if patient receiving conventional doses of drug; delayed hematologic suppression may occur; prompt reduction in dosage or temporary withdrawal of drug may be necessary if there is rapid fall in or persistently low leukocyte count, or other evidence of bone marrow depression; leukopenia does not correlate with therapeutic effect; therefore dose should not be increased intentionally to lower white blood cell countIn patients with severe myelosuppression, consider evaluation for TPMT and NUDT15 deficiency; consider alternative therapy in patients with homozygous TPMT or NUDT15 deficiency and reduced dosages in patients with heterozygous deficiencyPatients receiving immunosuppressants, are at increased risk for bacterial, viral, fungal,protozoal, and opportunistic infections, including reactivation of latent infections; these infections may lead to serious, including fatal outcomesFrequency of gastrointestinal adverse effects (nausea and vomiting) may decrease with dividing dose or administering after mealsLactation: Drug excreted at low levels in breast milk; use not recommendedA: Generally acceptable. The drug should be administered under the supervision of an experienced cancer chemotherapy physician Bone marrow suppression may occur. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC.

Individual plans may vary Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

When used at high doses in dose-ranging studies in patients with acute leukemia, fludarabine phosphate injection was associated with severe neurologic effects , including blindness , coma, and death.

25 mg/m2 IV over 30 minutes for 5 days every 28 days; following a maximal tumor response, 3 additional cycles are recommended Comments: -The optimal duration of treatment has not been clearly established.

Drugs -The dose may be decreased or delayed for hematologic or nonhematologic toxicity.

Fludarabine has been associated with severe neurologic effects, including blindness, coma when high doses were used in patients with acute leukemia. Transplantation (Off-label) Prevention of transplant rejection