Antimetabolites for Chemotherapy

Browse By All Topics


Antimetabolites for Chemotherapy


Generic NameBrand Name
cytarabine, cytosine arabinosideCytarabine, Cytosar-U, DepoCyt
hydroxyureaDroxia, Hydrea

How It Works

These chemotherapy medicines are classified as antimetabolites. Antimetabolites are medicines that interfere with the DNA and RNA inside cancer cells. They damage the cancer cells and prevent them from multiplying.

Why It Is Used

These chemotherapy medicines are used to treat acute leukemia, non-Hodgkin's lymphoma, and other cancers, such as breast or lung cancer.

How Well It Works

These medicines work well in treating cancer. But the type and extent of a cancer affects how well this medicine slows or stops the growth of those cancer cells.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Passed out (or lost consciousness).

Call your doctor right away if you have:

  • Hives.
  • Blurred vision or a sudden loss of vision.
  • Blood in your urine, frequent urination, or painful urination.
  • Fever or chills with or without cough, hoarseness, or lower back or side pain.
  • Strong feelings of restlessness, confusion, or are seeing, hearing, or feeling things that are not there.
  • Slurred speech and difficulty walking (ataxia).
  • Unusual tiredness, dizziness, or seizures.
  • Numbness, burning, and tingling in the hands or feet. This is from nerve damage and is called peripheral neuropathy. To prevent permanent nerve damage, you may need to have a lower dosage, stop using this medicine, or switch to a different medicine.

Capecitabine can cause serious bleeding and death when used in combination with blood-thinning drugs (anticoagulants), such as aspirin or warfarin (Coumadin). Tell your doctor if you are taking an anticoagulant drug. If you have any unusual bleeding or bruising, call your doctor immediately.

Hydroxyurea can cause skin ulcers, especially on the legs. But this is rare.

Nelarabine may affect your thinking or reactions. If it does, don't drive or do things that require you to be alert.

Common side effects of these medicines include:

  • Loss of appetite, nausea, or vomiting.
  • Skin rash, which may itch.
  • Diarrhea or constipation.
  • Sores in the mouth or throat.
  • Hair loss. This is reversible, and hair will grow back when treatment ends.
  • Changes in the way foods taste.
  • Weakness or fatigue.

These medicines may also cause:

  • Menstrual changes, symptoms of menopause (hot flashes and vaginal dryness), or early menopause in women.
  • Loss of fertility, including decreased sperm counts in men.
  • Low blood counts, which may make you tired and more likely to get an infection.
  • Sensitivity to sunlight. You may need to protect your skin from the sun.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Some of these medicines may interact with many other medicines. Be sure that your doctor has a complete list of all prescription and nonprescription medicines you are taking.

These medicines may cause very serious side effects and even death. Do not drink alcoholic beverages, including beer and wine, while you are being treated with these medicines.

Cytarabine is often given with another medicine called dexamethasone, especially when cytarabine is given in higher doses than usual. This is done to prevent a possibly fatal side effect called chemical arachnoiditis. This causes symptoms that include eye problems, nausea, vomiting, headache, and fever. You will be closely monitored while you are given cytarabine.

Fluorouracil is often given with another medicine called leucovorin. This can increase your chance of severe side effects.

Mercaptopurine can cause problems in people who inherit genes that make their bodies more sensitive to this medicine. So gene testing may be done before you get this medicine. This medicine can also cause blood, liver, kidney, or gastrointestinal problems, so your doctor will watch you closely for any changes and do any necessary testing.

Pemetrexed needs to taken along with vitamin B12, folate, and corticosteroids to decrease the risk of side effects from this medicine.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerBrian Leber, MDCM, FRCPC - Hematology
Last RevisedDecember 14, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.

How this information was developed to help you make better health decisions.

© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.