Leukemia Home > Clolar Warnings and Precautions

Reviewing your medical history and current medications with your healthcare provider before starting treatment with Clolar can help minimize potentially dangerous complications. Safety precautions with Clolar include warnings of serious drug interactions, allergic reactions, and dangerously low blood cell counts. Also, people who have liver or kidney damage may not be able to use this medicine.


What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving Clolar® (clofarabine) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Received a hematopoietic stem cell transplant
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Clolar

Some warnings and precautions to be aware of prior to receiving this medication include the following:
  • Clolar can cause bone marrow suppression (when the bone marrow is unable to produce adequate amounts of blood cells), which can lead to abnormally low white blood cells, red blood cells, and platelets. This can increase your risk for potentially serious infections, anemia, and bleeding problems.
  • Your healthcare provider will regularly monitor your blood counts using a simple blood test throughout treatment. Make sure to keep all of your healthcare appointments. Also, let your healthcare provider know if you experience signs of bone marrow suppression, such as:
    • Signs of low platelets, such as:
      • Any abnormal bleeding or bruising
      • Blood in your urine or stools
      • Black, tarry stools
      • Small red or purple spots under the skin
    • Signs of anemia, such as:
      • Fatigue
      • Weakness
      • Shortness of breath
      • Pale skin
    • Signs of infection, such as:
      • Fever
      • Chills
      • Sore throat
      • Cough or shortness of breath
      • Burning or pain when urinating.
  • Clolar can cause tumor lysis syndrome, which occurs when cancer cells that are rapidly destroyed by chemotherapy release their contents into the bloodstream faster than the body can remove them. This can cause a variety of metabolic and electrolyte imbalances, such as high levels of potassium, phosphate, and uric acid in the blood.

    Although generally rare, tumor lysis syndrome can be life-threatening, and can lead to problems such as kidney failure, an abnormal heart rhythm, and seizures. Your healthcare provider will monitor you for tumor lysis syndrome and give you medicines to prevent or treat it if necessary. 
  • This medication can cause a skin condition known as hand-foot syndrome. This condition can cause a tingling feeling, followed by redness, dryness, and flaking of the skin on the hands and feet. Your healthcare provider may recommend you apply a moisturizer. It is important to apply the moisturizer lightly and avoid rubbing the area too forcefully. Your healthcare provider may also prescribe medicines, such as steroids or antihistamines, to help relieve symptoms.
  • There have been reports of a potentially life-threatening reaction that can occur in response to a Clolar infusion. Let your healthcare provider know right away if you experience problems such as:
    • Difficulty breathing
    • Fast breathing
    • A fast heart rate
    • Dizziness
    • Lightheadedness
    • Fainting.
  • This medication has not been studied in people with kidney or liver disease, and should be used cautiously in such people.
  • Liver problems have been reported in people receiving this medication. People who have previously received a blood stem cell transplant may have a higher risk for developing liver problems after Clolar treatment.  
  • Clolar is a pregnancy Category D medication, which means it may harm an unborn child. Talk to your healthcare provider about the risks and benefits of using this medication when pregnant (see Clolar and Pregnancy).
  • It is unknown if Clolar passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving this drug (see Clolar and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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