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temozolomide temozolomide

 
  Trade/other name(s)
Temodar
 
  Pronunciation: tem-uh-zo-luh-mide  
  Why would this drug be used?
Temozolomide is used to treat brain cancers such as anaplastic astrocytoma, glioblastoma multiforme (GBM), and gliomas. Temozolide may also be used to treat other types of cancer.
 
  How does this drug work?
Temozolomide belongs to a group of chemotherapy drugs called alkylating agents. Unlike many other chemotherapy drugs, it can reach the brain from the bloodstream. It stops the growth of cancer cells, which causes them to die. Because the drug cannot tell the difference between normal cells and cancer cells, some normal cells may be injured as well.
 
  Before taking this medicine

Tell your doctor:
 
 
  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known if this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.
 
  Interactions with other drugs
Valproic acid (Depakote, Depakene) may have a small effect on the level of temozolomide in the body. If you are taking this drug, be sure to talk to your doctor, nurse, or pharmacist.

No other serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

 
  Interactions with foods
No serious interactions with food are known at this time, although it is recommended that the capsule form of this medicine be taken on an empty stomach or at bedtime to reduce the chance of nausea. Check with your pharmacist, doctor, or nurse for more information.
 
 
Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.


 
  How is this drug taken or given?
Temozolomide can be taken as capsules or given by an injection into a vein.

As an injection, temozolomide is given into a vein (IV) over about 90 minutes.

As a capsule, temozolomide comes in 6 sizes: 250 mg, 180 mg, 140 mg, 100 mg, 20 mg, and 5 mg.

The dose you receive depends on your height and weight, if you have received other chemotherapy before, and your blood counts.

For treatment of anaplastic astrocytoma, the drug is usually taken once a day for 5 days every 4 weeks.

For treatment of glioblastoma multiforme, the drug is usually taken daily for 6 weeks while radiation therapy is being given. Following a short rest period, the drug is then taken once a day for 5 days every 4 weeks, over a total of about 6 months.

Be sure of the exact dose and schedule of medicine before you start taking it. The capsules should be taken with a full glass of water on an empty stomach or at bedtime. Try to take the capsules at the same time each day. Do not crush, open, or dissolve the capsule. If the capsule is opened, keep its contents away from your eyes, nose, and mouth, being careful not to let them be inhaled. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

 
  Precautions
Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

Temozolomide can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Talk with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

Men and women should avoid trying to conceive (start a pregnancy) for at least 6 months after taking this drug.

Because of the way this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would likely be years after the drug is used. If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

 
 
Possible side effects
 
  Common
  • nausea
  • vomiting
  • diarrhea
  • constipation
  • loss of appetite
  • tiredness (fatigue)
  • weakness
  • slight hair loss
  • decrease in white blood cell count with increased risk of infection*
  • decrease in platelet count with increased risk of bleeding*
  • pain, itching, warmth, swelling, or redness at the injection site
  • bruising or small red or purple spots under the skin
 
  Less common
  • mouth sores
  • rash
  • itching
  • tiredness
  • headache
 
  Rare
  • decreased red blood cell count with increased risk of tiredness and anemia
  • trouble walking
  • dizziness
  • convulsions
  • a second type of cancer, which can happen years after this drug is taken*

*See the "Precautions" section for more detailed information.

 
 
There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.
 
 
 
  FDA approval
Yes - first approved in 1999.
 
 
 
  Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.  


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