Evoltra (Clofarabine)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Evoltra Used For?
Evoltra is a chemotherapy medicine that contains the active ingredient clofarabine. It belongs to a group of medicines called antineoplastic or cytotoxic agents.
Primary Uses
Evoltra is used to treat young patients with Acute Lymphoblastic Leukaemia (ALL) when previous treatments have not worked or have stopped working. ALL is caused by abnormal growth of some types of white blood cells. There is not enough information to recommend this medicine for children under 1 year old or adults over 65 years old.
How It Works
This medicine works by interfering with the growth and repair of cells that are multiplying rapidly, such as cancer cells, which are eventually destroyed.
How to Take Evoltra
Evoltra is given as a hospital treatment by trained medical professionals. You cannot take this medicine at home.
Dosage Instructions
Your doctor will decide your dose based on your condition, weight, height, and other chemotherapy medicines you’re receiving. Evoltra is given as a slow injection into a vein over 2 hours, usually every day for 5 days. If you weigh less than 20kg, the infusion time may be longer. Several courses may be needed depending on your response. Additional treatment may not be repeated until your blood cell numbers return to acceptable levels.
Important: Evoltra should only be given by a nurse or doctor in a hospital setting.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- nausea and vomiting
- diarrhea
- headache
- unusual tiredness or weakness
- anxiety or nervousness
- decreased or lost appetite, weight loss
- flushing, itching and inflamed skin
- skin rashes or flaking
- inflammation of mucus linings, such as the mouth
- fever
- infections
- hair loss
Seek immediate medical attention if you experience:
- severe nausea and vomiting
- severe diarrhea
- vomiting blood, stomach ache
- breathing difficulties, rapid breathing or breathlessness, cough
- nosebleeds, bleeding gums, mouth ulcers
- changes in your heart beat
- fluid retention (swelling)
- high fever
- hearing problems
- dizziness, light-headedness or fainting
- feeling thirsty and producing concentrated (dark) urine
- blood in the urine
- yellowing of the eyes and skin (jaundice)
- bruising, hair loss, changes to skin color
- increased sweating or dry skin
- feeling numb
- pain in the chest wall or bones
- neck or back pain, pain in the muscles or joints
- allergic reaction symptoms: shortness of breath, wheezing, difficulty breathing, swelling of face/lips/tongue, rash, itching or hives
Important Warnings
There are several important warnings and precautions to be aware of before and during treatment with Evoltra.
Who Should Not Take Evoltra
Do not use Evoltra if you are allergic to clofarabine or any ingredients in the medicine, or if you have severe kidney problems or severe liver problems.
Medical Conditions to Discuss
Tell your doctor if you have: infections or high temperature, blood disorders, bone marrow disease, kidney or liver disease, low blood pressure, gout, bowel problems like colitis, lowered immunity (including HIV/AIDS), heart disease, or if you’ve had Evoltra before and became unwell. Also inform your doctor if you’re on a controlled sodium diet, as each vial contains 70.77mg of sodium.
Pregnancy and Breastfeeding
Evoltra should not be used during pregnancy unless clearly necessary and may cause harm to unborn babies. Women who can get pregnant must use effective contraception during treatment and for 6 months after completion. Men must also use effective contraception and not father a child during treatment and for 3 months after completion. If breastfeeding, you must stop before starting treatment and not breastfeed during treatment and for 2 weeks after completion.
Pregnancy Risk: Evoltra may cause birth defects if either parent is using it at the time of conception. Call your doctor immediately if you become pregnant during treatment.
Drug Interactions
Some medicines may interfere with Evoltra and affect how it works. Always tell your doctor about all medicines you’re taking.
- other medicines used to treat cancer
- some vaccines
- medicines which can affect the kidneys
- medicines which can affect the liver
- medicines which can affect blood pressure or the heart
Alcohol & Driving
Be cautious with alcohol consumption and driving while receiving Evoltra treatment.
Alcohol
Tell your doctor if you drink alcohol. Be careful when drinking alcohol while receiving this medicine, as dizziness or light-headedness may be worse if you drink alcohol.
Driving and Operating Machinery
Be careful before you drive or use any machines or tools until you know how Evoltra affects you. You may feel dizzy or light-headed while receiving a cycle of Evoltra.
Storage
Evoltra will be stored in the pharmacy or on the hospital ward. The injection is kept in a cool, dry place where the temperature stays below 25°C. You do not need to worry about storing this medicine yourself.
Overdose Information
Since Evoltra is given in a hospital under medical supervision, overdose is very unlikely. However, if you think you have received too much, symptoms may include the side effects listed but more severe. If you suspect overdose, immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital Emergency Department, even if there are no signs of discomfort.
Frequently Asked Questions
Each Evoltra infusion takes 2 hours and is usually given daily for 5 days. If you weigh less than 20kg, the infusion time may be longer. Several courses may be needed depending on your response to treatment.
Drink plenty of water during treatment to avoid dehydration. Avoid people with infections and contact your doctor immediately if you think you’re getting an infection or develop fever, chills, cough, or other symptoms.
Be careful when using a toothbrush, toothpick, or dental floss. Check with your doctor before having any dental work, as Evoltra can lower your white blood cell and platelet counts, increasing bleeding risk.
Avoid contact sports or situations where you may bruise or get injured. Be careful with sharp objects like razors. Watch for signs of infection or unusual bleeding and contact your doctor immediately if these occur.
Your doctor will monitor your progress with regular appointments, blood pressure checks, and blood tests. Keep all follow-up appointments to get the best effects from your treatment.
Contact your doctor if you have less serious side effects that worry you. Call your doctor straight away or go to the Emergency Department if you notice any serious side effects like severe nausea, breathing difficulties, or signs of allergic reaction.
No, you must use effective contraception during treatment and for 6 months after completion if you’re a woman, or 3 months if you’re a man. Call your doctor immediately if you become pregnant during treatment, as Evoltra may cause birth defects.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.