Currently, only three agents are licensed for intrathecal chemotherapy
They are methotrexate, cytarabine (a.k.a. Ara-C) and hydrocortisone
Today we made an intrathecal chemo with MTX and hydrocortisone in the same syringe. The MTX must be diluted to 2.5-5 mg/ml. You must use all PF products when mixing items for intrathecal use!! To use the hydrocortisone, the diluent in the acti-vial is NOT PF and therefore you have to pull out the diluent and replace it with PF NS.
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It's apparently used for the prevention of Lymphoma relapsing into the CNS. The pt reported a headache for approximately a week after getting the MTX alone, so hopefully the Hydrocortisone added to it decreases that effect for the pt!
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