Care During Chemotherapy and Beyond
Generic name: Clofarabine
Clolar® is the trade name for the generic chemotherapy drug clofarabine. In some
cases, health care professionals may use the generic name clofarabine when referring
to the trade name Clolar®.
Drug type: Clolar® is an anti-cancer ("antineoplastic" or "cytotoxic")
chemotherapy drug. This medication is classified as an "antimetabolite." (For more
detail, see "How this drug works" section below).
What Clolar® Is Used For:
- Indicated for the treatment of pediatric patients, 1 to 21 years old, with relapsed
or refractory acute lymphoblastic leukemia (ALL) after at least 2 prior regimens.
Note: If a drug has been approved for one use, physicians may elect
to use this same drug for other problems if they believe it may be helpful.
How Clolar® Is Given:
- Clolar® is given through a vein by intravenous injection (IV).
The amount of Clolar® that you will receive depends on many factors, including your
age, height and weight, your general health or other health problems, and the type
of cancer or condition being treated. Your doctor will determine your dose and schedule.
Clolar® Side Effects:
Important things to remember about the side effects of Clolar®:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and
the effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking Clolar®:
These side effects are less common side effects (occurring in about 10-29%)
of patients receiving Clolar®:
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your health
care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms and go
to the Emergency Room:
Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
Signs of a reaction to the medication (wheezing; chest tightness; fever; itching;
bad cough; blue or grey skin color; seizures; or swelling of the face, lips, tongue
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours
of noticing any of the following:
- Yellowing of the skin or eyes
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools or urine
- Very bad headache
- Not able to pass urine
- Change in thinking clearly and with logic
- Extreme fatigue (unable to carry on self-care activities)
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Diarrhea (4-6 episodes in a 24-hour period)
- Mouth sores (painful redness, swelling or ulcers)
- A burning or tingling that is not normal
- Very bad skin irritation
- Any rash
- Other signs of infection such as very bad sore throat, ear or sinus pain, cough,
more sputum or change in the color of the sputum, painful urination, mouth sores,
wound that will not heal, or anal itching or pain
Always inform your health care provider if you experience any unusual symptoms.
Before starting Clolar® treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not receive any kind of immunization or vaccination without
your doctor's approval while taking Clolar®.
Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Clolar® may be hazardous to the
fetus. Women who are pregnant or become pregnant must be advised of the potential
hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking Clolar®.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
You may be at risk of infection so try to avoid crowds or people with colds and
those not feeling well, and report fever or any other signs of infection immediately
to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed
with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
If you should experience nausea, take anti-nausea medications as prescribed by
your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may
Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
If you experience symptoms or side effects, be sure to discuss them with your
health care team. They can prescribe medications and/or offer other suggestions
that are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you
are taking Clolar®, to monitor side effects and check your response to therapy.
Periodic blood work to monitor your complete blood count (CBC) as well as the function
of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How This Drug Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come into contact
with like cells, a mechanism known as contact inhibition. Cancerous cells lose this
ability. Cancer cells no longer have the normal checks and balances in place that
control and limit cell division. The process of cell division, whether normal or
cancerous cells, is through the cell cycle. The cell cycle goes from the resting
phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells the
cell how to copy itself in division. If the cells are unable to divide, they die.
The faster the cells are dividing, the more likely it is that chemotherapy will
kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the type
of cells, rate at which they divide, and the time at which a given drug is likely
to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately,
chemotherapy does not know the difference between the cancerous cells and the normal
cells. The "normal" cells will grow back and be healthy but in the meantime, side
effects occur. The "normal" cells most commonly affected by chemotherapy are the
blood cells, the cells in the mouth, stomach and bowel, and the hair follicles;
resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.
Different drugs may affect different parts of the body.
Clolar® belongs to the class of chemotherapy drugs called antimetabolites. Antimetabolites
are very similar to normal substances within the cell. When the cells incorporate
these substances into the cellular metabolism, they are unable to divide. Antimetabolites
are cell-cycle specific. They attack cells at very specific phases in the cycle.
Antimetabolites are classified according to the substances with which they interfere.
- Folic acid antagonist: methotrexate.
- Pyrimidine antagonist: 5-fluorouracil, foxuridine, cytarabine,
capecitabine, and gemcitabine.
- Purine antagonist: 6-mercaptopurine, 6-thioguanine and
- Adenosine deaminase inhibitor: cladribine, fludarabine and pentostatin.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org