Acute Porphyria Drug Database

L01BB07 - Nelarabine
Not porphyrinogenic
NP

Rationale
Non-CYP metabolism. However, side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Nelarabine is a precursor to the deoxyguanosine analogue ara-G.
Therapeutic characteristics
Nelarabine is an antimetabolite antineoplastic agent used to treat therapy-resistent acute lymphocytic leucemia of T-cell type and T-cell lymphoblastic lymphoma. Administered as intravenous infusion. Common adverse reactions of nalarabine that can be confused with an acute porphyric attack are nausea, vomiting, obstipation, diarrhoea, abdominal pain and myalgia. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Nelarabine is rapidly and extensively converted by demethylation to the cytotoxic guanine arabinoside that has a half life elimination time from plasma of 3 hours. Nelarabine also undergoes hydrolysis to form methylguanine. Both methylguanine and guanine arabinoside are further metabolized to guanine, which is deaminated to form xantine and finally oxidized to uric acid. Nelarabine does not appear to substantially inhibit any of the cytochrome P-450 (CYP) isoenzymes.
IPNet drug reports
No.

References

  1. Drug reference publications
  2. McEvoy GK, editor. Nelarabine. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (03.12.09). #3334
  3. Sweetman SC, editor. Martindale: The complete drug reference. Nelarabine. Pharmaceutical Press 2009. #3336
  4. Summary of Product Characteristics
  5. Norwegian medicines agency. Summary of Product Characteristics (SPC). ATRIANCE. #3335

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