Azacitidine

Azacitidine Brand Name– Vidaza

What is Azacitidine

Azacitidine is a pyrimidine nucleoside analog that inhibits RNA and DNA synthesis.

It is indicated for the treatment of patients with the following myelodysplastic syndrome subtypes: refractory anemia or refractory anemia with ringed sideroblasts (if accompanied by neutropenia or thrombocytopenia or requiring transfusions), refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia.

Azacitidine was approved by the FDA in 2004.

Indications

  • acute myelogenous leukemia (AML)
  • chronic myelogenous leukemia (CML)
  • myelodysplastic syndrome (MDS)

For the treatment of myelodysplastic syndrome (MDS)

NOTE: Azacitidine has been designated an orphan drug for this indication.

for the treatment of MDS subtypes of refractory anemia or refractory anemia with ringed sideroblasts (if accompanied by neutropenia or thrombocytopenia or requiring transfusions), refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. agranulocytosis
  4. anaphylactic shock
  5. anemia
  6. anemia
  7. anorexia
  8. anxiety
  9. arthralgia
  10. atrial fibrillation
  11. bleeding
  12. bone pain
  13. cardiac arrest
  14. cardiomyopathy
  15. chest pain (unspecified)
  16. cholecystitis
  17. coma
  18. constipation
  19. constipation
  20. dehydration
  21. diarrhea
  22. differentiation syndrome
  23. dizziness
  24. dyspepsia
  25. dyspnea
  26. dyspnea
  27. ecchymosis
  28. erythema
  29. fatigue
  30. fatigue
  31. fever
  32. fever
  33. GI bleeding
  34. headache
  35. heart failure
  36. hematoma
  37. hematuria
  38. hematuria
  39. hemoptysis
  40. hypertension
  41. hypertension
  42. hypokalemia
  43. hypokalemia
  44. hypotension
  45. infection
  46. infection
  47. injection site reaction
  48. insomnia
  49. intracranial bleeding
  50. lethargy
  51. leukopenia
  52. leukopenia
  53. malaise
  54. melena
  55. myalgia
  56. nausea
  57. nausea
  58. necrotizing fasciitis
  59. neutropenia
  60. neutropenia
  61. new primary malignancy
  62. ocular hemorrhage
  63. orthostatic hypotension
  64. pancytopenia
  65. petechiae
  66. petechiae
  67. pharyngitis
  68. pneumonitis
  69. pruritus
  70. rash
  71. renal failure (unspecified)
  72. renal tubular acidosis (RTA)
  73. respiratory arrest
  74. seizures
  75. skin necrosis
  76. splenomegaly
  77. stomatitis
  78. thrombocytopenia
  79. thrombocytopenia
  80. tumor lysis syndrome (TLS)
  81. urticaria
  82. vomiting
  83. weakness
  84. weight loss
  85. weight loss
  86. xerosis

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum bicarbonate
  • serum creatinine/BUN
  • serum electrolytes
  • serum uric acid

Contraindications

  • bone marrow suppression
  • breast-feeding
  • contraception requirements
  • geriatric
  • hepatic disease
  • hepatotoxicity
  • hypoalbuminemia
  • infertility
  • male-mediated teratogenicity
  • mannitol hypersensitivity
  • neutropenia
  • pregnancy
  • pregnancy testing
  • renal failure
  • renal impairment
  • reproductive risk
  • thrombocytopenia
  • tumor lysis syndrome (TLS)

Interactions

  • Palifermin
  • Penicillamine
  • Tuberculin Purified Protein Derivative, PPD
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