Fludarabine Phosphate

Adults: Fludarabine injection should be given only under the supervision of a physician experienced in antineoplastic therapy. The recommended dose is 25 mg Fludarabinebine phosphate per square metre of body surface, given daily for 5 consecutive days, repeated every 28 days, administered by the intravenous route. Each vial is reconstituted with 2 ml of water for injection, giving a solution in which each ml contains 25 mg Fludarabinebine phosphate. The dose required, calculated from the patient's body surface area, is drawn up into a syringe. For a bolus intravenous injection, this dose is diluted further into 10 ml of 0.9% sodium chloride; alternatively, for an infusion, the dose drawn up in the syringe can instead be diluted into 100 ml of 0.9% sodium chloride and infused over approximately 30 minutes. How long treatment continues depends on how well it is working and how well the patient tolerates it. In patients with CLL, Fludarabine should be given until the best response is reached, whether complete or partial remission, usually around 6 cycles, after which the drug should be discontinued. In patients with Lg-NHL, treatment with Fludarabine is recommended until the best response is achieved, and two cycles of consolidation should be considered once that best response has been reached; in clinical trials in Lg-NHL, most patients received no more than 8 cycles in total. Fludarabine tablets are usually started at a dose of 40 mg/m2 of Fludarabinebine phosphate, given once daily for five consecutive days, repeated every 28 days. As with the injection, the duration of treatment depends on how well it is working and how well the drug is tolerated. Fludarabine taken orally should be continued until the maximal response is reached, whether complete or partial remission, usually around 6 cycles, and then the drug should be discontinued.