Fludara Oral (Fludarabine Phosphate)
Complete patient guide for uses, dosage, side effects, and safety information
Quick Facts
What Is Fludara Oral Used For?
Fludara Oral is an anti-cancer medication specifically designed to treat a type of blood cancer called B-cell chronic lymphocytic leukaemia (B-CLL).
Primary Uses
Fludara Oral is approved to treat B-cell chronic lymphocytic leukaemia (B-CLL), which is a cancer affecting white blood cells called lymphocytes. In this condition, patients have too many abnormal white blood cells that cannot fight disease properly, and lymph nodes begin to grow throughout the body.
How It Works
Fludara Oral works by stopping cancer cells from growing. It interferes with the cancer cells’ ability to produce new DNA, which prevents them from dividing and creating new cancer cells. The medication is absorbed by cancer cells and disrupts their genetic material reproduction process.
Important: This medication helps control your condition but does not cure it. It’s important to continue taking it even if you feel better.
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How to Take Fludara Oral
Fludara Oral should be taken exactly as prescribed by your doctor. The dosage is carefully calculated based on your body surface area and response to treatment.
Dosage Instructions
The recommended dose is 40mg per square metre of body surface area, once daily. This typically equals 3 to 10 tablets once a day. Swallow tablets whole with a full glass of water – do not chew or break them. Take at the same time each day for 5 consecutive days. This 5-day treatment cycle is repeated every 28 days, usually for 6 courses. Can be taken with or without food.
What If You Miss a Dose?
If you miss a dose or vomit after taking tablets, contact your doctor as soon as possible for guidance. Do not take a double dose to make up for the missed dose, as this may increase your risk of side effects.
Important: Never double dose to make up for a missed dose – this increases the risk of serious side effects.
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:
- Infections with fever, chills, sore throat
- Symptoms of anaemia (tiredness, headaches, shortness of breath, dizziness, pale appearance)
- Some bruising
- Loss of appetite and weight loss
- Numbness or weakness in arms and legs
- Cough
- Nausea, vomiting, diarrhoea
- Sore mouth, gums, or mouth ulcers
- Skin rash
- Fever, tiredness, chills, weakness
- Swelling due to fluid retention
Seek immediate medical attention if you experience:
- Severe bruising or excessive bleeding after injury
- Frequent infections
- New or unusual skin changes (moles, freckles, sores)
- Pneumonia symptoms (fever, chills, shortness of breath, bloody phlegm)
- Visual disturbances or sudden vision loss
- Allergic reactions (rash, swelling, breathing difficulties)
- Red or brown urine, skin blisters
- Vomiting blood or coffee-ground material, bloody stools
- Seizures or unconsciousness
- Heart problems (irregular heartbeat, chest pain, swelling)
- Tumour lysis syndrome
- Stevens-Johnson syndrome or toxic epidermal necrolysis
- Neurological disorders including leukoencephalopathy
- Lung bleeding
- Bladder inflammation with painful urination
Important Warnings
There are several important safety considerations before starting Fludara Oral treatment.
Who Should Not Take Fludara Oral
Do not take if you are allergic to fludarabine phosphate or any ingredients, are pregnant or breastfeeding, have low red blood cell count due to haemolytic anaemia, or have severe kidney problems.
Medical Conditions to Discuss
Tell your doctor if you have: allergies to medicines/foods/dyes, low blood protein levels, unusual bruising or frequent infections, poor kidney function, enlarged liver or spleen, skin cancer history, are over 75 years old, or take other medications.
Pregnancy and Breastfeeding
Fludara Oral must not be used during pregnancy or breastfeeding. Both men and women must use effective contraception during treatment and for 6 months after stopping. Men should seek advice about sperm conservation before treatment as fertility may be affected. Genetic counselling is required before starting treatment.
Skin Cancer Risk: If you have had skin cancer, it may worsen or return during treatment. You may also develop new skin cancers as this medication reduces your body’s defense mechanisms.
Drug Interactions
Several medications can interfere with Fludara Oral and affect how it works or increase the risk of serious side effects.
Dangerous Combination: Taking Fludara Oral with Pentostatin can lead to severe, potentially life-threatening lung problems.
- Pentostatin (deoxycoformycin) – can cause severe lung problems when combined
- Cytarabine (Ara-C) – used for chronic lymphatic leukaemia
- Dipyridamole – used to prevent blood clotting
- Live viral vaccines – should be avoided during and after treatment
Alcohol & Driving
Fludara Oral can affect your ability to drive safely and may interact with alcohol consumption.
Alcohol
Tell your doctor if you drink alcohol. The interaction between Fludara Oral and alcohol should be discussed with your healthcare provider.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Fludara Oral affects you. This medication may cause fatigue, weakness, visual disturbances, confusion, agitation, and rarely seizures. If you experience any of these symptoms, do not drive or operate machinery.
Storage
Keep tablets in their original pack until time to take them. Store in a cool, dry place where temperature stays below 25°C. Avoid heat, dampness, bathrooms, cars, and window sills. Keep away from children in a locked cupboard at least 1.5 metres above ground. Do not use after expiry date.
Overdose Information
If you think you have taken too much Fludara Oral, seek urgent medical attention immediately. Overdose can cause delayed blindness, coma, and even death. Call the Poisons Information Centre on 13 11 26, contact your doctor, or go to the nearest hospital emergency department, even if you feel fine.
Frequently Asked Questions
Fludara Oral is typically given in cycles of 5 days every 28 days, usually for 6 courses. Your doctor will monitor your blood tests after each treatment course to assess your response to therapy and determine when the best effect has been achieved.
Yes, Fludara Oral can be taken either on an empty stomach or with food. Take the tablets at the same time each day with a full glass of water.
Do not stop taking Fludara Oral or change the dosage without checking with your doctor first. If you stop taking it suddenly, your condition may worsen. This medication helps control your condition and it’s important to continue taking it even if you feel better.
You should tell your doctor if you drink alcohol. The interaction between Fludara Oral and alcohol needs to be discussed with your healthcare provider before consuming alcohol during treatment.
You will have blood tests after every treatment course so your doctor can monitor your blood cell counts and adjust your dose accordingly. Some side effects can only be detected through regular blood tests, and this helps ensure the medication is working safely.
Check with your doctor before receiving any vaccinations. Live viral vaccines should be avoided during and after treatment with Fludara Oral. Your doctor will advise which vaccines are safe for you.
Tell your doctor immediately if you need a blood transfusion. Your doctor will ensure you receive blood that has been treated by irradiation, as there have been severe complications and even death from transfusion of non-irradiated blood in patients taking Fludara Oral.
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.