Overdose : מינון יתר

4.9 Overdose
A chronic overdose can result in severe bone marrow suppression inter alia accompanied by massive haemorrhage and life-threatening infections as well as neurotoxicity.

The myelotoxicity of cytarabine is dose-limiting. During high-dose therapy using cumulative total doses of approx. 18-36 g cytarabine per treatment cycle, severe myelotoxicity including myelophthisis must be expected. This myelotoxicity is dose- dependent and depends, among others, on the patient’s age, clinical condition and bone marrow reserves as well as other additional myelotoxic treatment. The full clinical picture appears 1 to 2 weeks after administration.

Haematological parameters must be checked frequently over an extended period of time, even in the case of a suspected overdose. As effective antidotes are not available, the utmost caution is mandatory for each application.

In case of overdose suitable supportive measures (e.g. Cessation of therapy, blood transfusions, antibiotic therapy) are indicated.
In the case of severe accidental intrathecal overdose, the CSF is to be replaced with isotonic sodium chloride solution as soon as possible.

Tweleve doses of 4.5 g/m2 by IV infusion over one hour every 12 hours induces irreversible and fatal central nervous system toxicity.
Cytarabine can be haemodialysed. However, information regarding the efficacy in the case of overdose is not available.