Temozolomide

What is Temozolomide

Temozolomide is an alkylating agent that is indicated for the treatment of newly diagnosed glioblastoma multiforme in combination with radiotherapy followed by monotherapy maintenance therapy and for the treatment of refractory anaplastic astrocytoma in patients who have experienced disease progression after a nitrosourea and procarbazine-containing regimen.

Severe hematologic toxicity and hepatotoxicity have been reported with temozolomide therapy.

Brand Name

TEMODAR

Indications

  1. astrocytoma
  2. glioblastoma multiforme
  3. malignant glioma
  4. malignant melanoma

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. alopecia
  4. amnesia
  5. amnesia
  6. anaphylactoid reactions
  7. anemia
  8. anorexia
  9. anorexia
  10. anxiety
  11. anxiety
  12. aplastic anemia
  13. arthralgia
  14. arthralgia
  15. asthenia
  16. asthenia
  17. ataxia
  18. ataxia
  19. back pain
  20. back pain
  21. blurred vision
  22. blurred vision
  23. cholestasis
  24. confusion
  25. confusion
  26. constipation
  27. constipation
  28. cough
  29. cough
  30. Cushing’s syndrome
  31. depression
  32. diabetes insipidus
  33. diarrhea
  34. diarrhea
  35. diplopia
  36. dizziness
  37. dizziness
  38. drowsiness
  39. drowsiness
  40. dysgeusia
  41. dysphagia
  42. dysphagia
  43. dyspnea
  44. dyspnea
  45. edema
  46. elevated hepatic enzymes
  47. erythema
  48. erythema multiforme
  49. fatigue
  50. fatigue
  51. fever
  52. fever
  53. headache
  54. headache
  55. hematoma
  56. hepatitis
  57. hyperbilirubinemia
  58. increased urinary frequency
  59. infection
  60. injection site reaction
  61. insomnia
  62. leukopenia
  63. lymphopenia
  64. mastalgia
  65. memory impairment
  66. memory impairment
  67. myalgia
  68. nausea
  69. nausea
  70. neutropenia
  71. new primary malignancy
  72. pancytopenia
  73. paresis
  74. paresis
  75. paresthesias
  76. paresthesias
  77. peripheral edema
  78. peripheral edema
  79. petechiae
  80. pharyngitis
  81. pneumonitis
  82. pruritus
  83. pruritus
  84. pulmonary fibrosis
  85. rash
  86. rash
  87. seizures
  88. sinusitis
  89. skin irritation
  90. spontaneous fetal abortion
  91. Stevens-Johnson syndrome
  92. stomatitis
  93. stomatitis
  94. teratogenesis
  95. thrombocytopenia
  96. thrombocytopenia
  97. toxic epidermal necrolysis
  98. urinary incontinence
  99. urinary incontinence
  100. visual impairment
  101. vomiting
  102. vomiting
  103. weakness
  104. weakness
  105. weight gain
  106. xerosis
  107. xerosis

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing

Contraindications

  • aplastic anemia
  • bone marrow suppression
  • breast-feeding
  • children
  • contraception requirements
  • dacarbazine (DTIC) hypersensitivity
  • females
  • gelatin hypersensitivity
  • geriatric
  • glioblastoma multiforme
  • hepatic disease
  • hepatotoxicity
  • infants
  • infection
  • infertility
  • male-mediated teratogenicity
  • mannitol hypersensitivity
  • neonates
  • neutropenia
  • pregnancy
  • pregnancy testing
  • renal disease
  • renal impairment
  • reproductive risk
  • serious rash
  • sperm donation
  • thrombocytopenia
  • urticaria

Interactions

  • Aldesleukin, IL-2
  • Amlodipine; Celecoxib
  • Celecoxib
  • Clozapine
  • Cyclophosphamide
  • Cyclosporine
  • Daclizumab
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Efalizumab
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Flucytosine
  • Flurbiprofen
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Methotrexate
  • Muromonab-CD3
  • Mycophenolate
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Penicillamine
  • Piroxicam
  • Rofecoxib
  • Sirolimus
  • Sulindac
  • Tacrolimus
  • Tolmetin
  • Tuberculin Purified Protein Derivative, PPD
  • Valdecoxib
  • Valproic Acid, Divalproex Sodium
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