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Dacarbazine

(da-kar-ba-zeen)

Trade/other name(s): DTIC-Dome, dimethyl-triazeno, imidazole carboxamide

Why would this drug be used?

Dacarbazine is used to treat Hodgkin disease and malignant melanoma. It may also be used for other types of cancer and even some conditions other than cancer.

How does this drug work?

Dacarbazine is a chemotherapy drug that has the same effect as an alkylating agent. It helps to stop cancer cells from growing, causing them to die.

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. 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 whether 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 short-term or long-term 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. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Any drugs or supplements that interfere with blood clotting can raise the risk of bleeding during treatment with dacarbazine. These include:

  • vitamin E
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and many others
  • warfarin (Coumadin)
  • ticlopidine (Ticlid)
  • clopidogrel (Plavix)

Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't sure what's in the medicines you take.

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. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Dacarbazine is given as an injection in a vein over a 20-minute period or longer. Tell the nurse if you feel pain, burning, or discomfort in the vein when the shot is given. You will be given medicine before the dacarbazine to help stop any nausea or vomiting.

The dose and how often you get the medicine depends on your size, blood counts, and the type of cancer you are being treated for. Your blood counts will be checked before each treatment; and if they are too low, your treatment may be delayed. You may be given other anti-cancer medicines along with this one.

Precautions

This drug is given into the vein (IV). If the drug leaks out of the vein and under the skin, it may damage the tissue. Tell the doctor or nurse right away if you notice redness, pain, swelling or other symptoms at or near the IV.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. Dacarbazine may affect your immune system. This could make vaccinations ineffective, or even lead to serious infections if you get a live virus vaccine during or soon after treatment. Try to avoid contact with people who have recently received a vaccine with a live virus, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

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 completely. Keep all your appointments for lab tests and doctor visits.

This drug 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 you pass 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.

Dacarbazine can make you very sensitive to sunlight or bright ultraviolet light, with redness, rash, hives, itching or other symptoms if exposed. When possible, avoid being outdoors between the hours of 10 and 4. Wear sunglasses, hat, and protective clothes when outside, even on hazy days. Always apply sunscreen half an hour before going out in the sun, and follow the instructions for repeat applications. Avoid tanning beds.

Because of the way this drug and the others that are given with it act on cells in the body, you may have a higher 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 thinks 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

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • low white blood cell count with increased risk of infection*
  • low platelet count with increased risk of bleeding*
  • nausea*
  • vomiting*
  • loss of appetite
  • irritation of vein used for giving the drug
  • flu–like illness up to 7 days after receiving the drug (tiredness, headache, muscle aches, fever)
  • hair loss or thinning, including face and body hair

Less common

  • taste changes, including metallic taste of foods
  • hardening of vein used for giving the drug
  • tiredness (fatigue)
  • anemia (low red blood cell count, with tiredness, dizziness, or shortness of breath)
  • birth defects if taken during pregnancy
  • short-term or long-term infertility (inability to have children)

Rare

  • diarrhea
  • facial flushing
  • liver damage
  • redness and itching at injection site
  • severe allergic reaction with symptoms like hives, itching, swelling in the mouth, face, or throat, and trouble breathing or swallowing
  • extreme sensitivity to sun and UV light for up to 4 days after dose*
  • death from liver damage, infection, bleeding, or other causes

*See "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 before 1984 (FDA cannot verify dates of drugs approved before 1984.)

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.

Last Medical Review: 01/12/2010
Last Revised: 01/12/2010