Comparative Pharmacology
Head-to-head clinical analysis: FLUDARA versus NOVANTRONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FLUDARA versus NOVANTRONE.
FLUDARA vs NOVANTRONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fludarabine is a purine nucleotide analog that inhibits DNA synthesis by interfering with ribonucleotide reductase and DNA polymerase, leading to cell death in dividing lymphocytes.
Mitoxantrone is a synthetic anthracenedione derivative that intercalates with DNA and inhibits topoisomerase II, leading to DNA strand breaks and inhibition of DNA and RNA synthesis. It also disrupts DNA repair and replication, and has immunosuppressive effects through inhibition of B cell, T cell, and macrophage function.
25 mg/m^2 intravenously over 30 minutes daily for 5 consecutive days every 28 days.
12 mg/m2 IV over 5-15 minutes once daily on days 1-3 of a 28-day cycle, or as a single dose of 12-14 mg/m2 IV every 21 days. For acute nonlymphocytic leukemia, 12 mg/m2 IV daily for 3 days with cytarabine.
None Documented
None Documented
Clinical Note
moderateFludarabine + Digoxin
"Fludarabine may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateFludarabine + Digitoxin
"Fludarabine may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateFludarabine + Deslanoside
"Fludarabine may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateFludarabine + Acetyldigitoxin
"Fludarabine may decrease the cardiotoxic activities of Acetyldigitoxin."
Fludarabine phosphate: 0.7-1 h (rapid dephosphorylation). Active metabolite 2-fluoro-ara-A: terminal t1/2 20-30 h (up to 40 h in renal impairment).
Terminal elimination half-life: 23-215 hours (mean ~37 hours). The long half-life reflects extensive tissue distribution and slow elimination, allowing weekly dosing.
Renal: 60% excreted unchanged in urine; biliary/fecal: <5% as metabolites.
Primarily hepatic (biliary/fecal) elimination: ~25% as unchanged drug and metabolites in feces over 5 days; renal excretion accounts for ~11% (6-11%) as unchanged drug. Less than 10% excreted unchanged in urine.
Category C
Category C
Antineoplastic Agent
Antineoplastic Agent