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An 1H NMR study of the cytarabine degradation in clinical conditions to avoid drug waste, decrease therapy costs and improve patient compliance in acute leukemia
- Source :
- Anti-Cancer Drugs
- Publication Year :
- 2020
-
Abstract
- Cytarabine, the 4-amino-1-(β-D-arabinofuranosyl)-2(1H)-pyrimidinone, (ARA-C) is an antimetabolite cytidine analogue used worldwide as key drug in the management of leukaemia. As specified in the manufacturers' instructions, once the components-sterile water and cytarabine powder-are unpackaged and mixed, the solution begins to degrade after 6 hours at room temperature and 12 hours at 4°C. To evaluate how to avoid wasting the drug in short-term, low-dose treatment regimens, the reconstituted samples, stored at 25°C and 4°C, were analyzed every day of the test week by reversed-phase HPLC and high-field NMR spectroscopy. All the samples remained unchanged for the entire week, which corresponds to the time required to administer the entire commercial drug package during low-dose therapeutic regimens. The drug solution was stored in a glass container at 4°C in an ordinary freezer and drawn with sterile plastic syringes; during this period, no bacterial or fungal contamination was observed. Our findings show that an cytarabine solution prepared and stored in the original vials retains its efficacy and safety and can, therefore, be divided into small doses to be administered over more days, thus avoiding unnecessary expensive and harmful waste of the drug preparation. Moreover, patients who require daily administration of the drug could undergo the infusion at home without need to go to hospital. The stability of the aliquots would help decrease hospitalization costs.
- Subjects :
- 0301 basic medicine
Drug
Cancer Research
Antimetabolites, Antineoplastic
medicine.drug_class
media_common.quotation_subject
Drug Storage
Fungal contamination
Vial
Antimetabolite
Drug Costs
Medication Adherence
03 medical and health sciences
0302 clinical medicine
Drug Stability
Cost Savings
Pharmaceutical Preparations, acute leukemia,cytarabine, supportive care
Medicine
Humans
Pharmacology (medical)
acute leukemia
Patient compliance
Nuclear Magnetic Resonance, Biomolecular
Chromatography, High Pressure Liquid
media_common
Pharmacology
Acute leukemia
Clinical Report
business.industry
Cytarabine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Solutions
supportive care
Leukemia, Myeloid, Acute
030104 developmental biology
Oncology
Drug Package
030220 oncology & carcinogenesis
Anesthesia
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Anti-Cancer Drugs
- Accession number :
- edsair.doi.dedup.....1b1cc014d33c151401903638b0d3cd70