Biobin 100mg/1ml Injection (Cytarabine)

Biobin 100gm/1ml injection contains cytarabine (cytosine arabinoside), an antimetabolite chemotherapy medicine used in acute myeloid leukemia (AML) treatment. It is also used in acute lymphoblastic leukemia and selected lymphoma regimens and, in preservative-free formulations.

Cytarabine injection can be administered intrathecally for meningeal leukemia. However, the medicine works by converting inside cells to an active triphosphate that blocks DNA synthesis. Therefore, the 1 g vial/10 mL strength is not a standard patient dose: conventional and high-dose regimens differ by more than ten-fold and are calculated in mg/m². Hence, patients are advised to use the medication only under medical supervision for safe and effective treatment.

Uses of Cytarabine Injection include:

• Acute Myeloid Leukemia (AML)
• Acute Lymphoblastic Leukemia (ALL)
• Some aggressive lymphomas

The medicine is essential for AML treatment and, particularly, for its induction and consolidation phases. Induction usually involves continuous infusion of cytarabine 100gm/1ml injection along with anthracyclines under the "7+3" protocol, whereas consolidation and salvage therapy usually use high-dose cytarabine 100gm/1ml. The injection without preservatives can also be given by the intrathecal route for prophylaxis or treatment of leukaemia meningeal involvement. Careful consideration of the route, dose, and formulation of the medicine is necessary since cytarabine injection preparations with preservatives should not be administered intrathecally.​

The drug Biobin 100gm/1ml Injection is converted into its active form, known as cytarabine triphosphate (ara-CTP), within the cell. The ara-CTP inhibits the nucleotides required for the synthesis of DNA as well as DNA polymerase, which is essential for DNA synthesis. Consequently, the cancer cells lack the ability to synthesize DNA and reproduce normally. However, the mode of action of cytarabine 100gm/1ml injection is selective for cells that synthesize DNA.

7+3 AML induction: Over many years, scientific research has proved that the combination of Biobin 100gm/1ml injection with an anthracycline has become a standard way of treating AML.
High-dose cytarabine consolidation: Clinical studies have demonstrated the effectiveness of using high doses of cytarabine injection in decreasing the likelihood of recurrence of AML, especially in young and healthy patients.

Just like any other medication, Biobin 100gm/1ml injection is also associated with some side effects. Most of the side effects are minor and usually go away within some time.

Common side effects

• Low blood counts
• Fever/infection
• Nausea/vomiting
• Mouth sores
• Rash
• Diarrhea
• Liver enzyme elevations
  

Serious side effects

• Severe myelosuppression/sepsis
• Cerebellar neurotoxicity at high doses
• Severe conjunctivitis/keratitis
• Pulmonary toxicity
• Cytarabine syndrome
• Gastrointestinal ulceration/necrosis

Important: Dose and regimen must be prescribed by the treating specialist. Tablet/vial strength is not necessarily the patient dose. Do not start, stop, split, combine, or substitute treatment based on website information.

If a chemotherapy dose is delayed, contact the hematology/oncology department to ensure the correct schedule of the medication after missing it. Do not self-reschedule. High-dose and intrathecal schedules are protocol-specific, and missing a dose may require the entire cycle to be re-planned.

• Blood tests are frequently performed in order to assess red blood cells, white blood cells, and platelets.
• The functioning of the kidneys and liver is assessed to ensure that the patient's body can tolerate the therapy.
• With a high-dose cytarabine 100gm/1ml injection, the signs of confusion, impaired coordination, speech difficulties, and any other neurological symptoms are assessed.
• Eye symptoms, such as redness, pain, irritation, and blurred vision, are assessed.
• The temperature and signs of infection are assessed, particularly if there are low levels of white blood cells.
• If there are high levels of cancer cells in the patient, tests can be performed to assess the risk of developing tumor lysis syndrome.
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• Current cytarabine injection prescribing information https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/071868s032lbl.pdf​
• Current AML guidelines (NCCN/ELN) for induction and consolidation https://jnccn.org/view/journals/jnccn/24/6/article-p222.xml?print​
• Landmark AML cytarabine dose/intensity studies https://pubmed.ncbi.nlm.nih.gov/38861379/​​