Temozolomide: An Oral Alkylating Agent

What is temozolomide: 

As an oral alkylating agent, Temozolomide is approved in order to treat newly diagnosed glioblastoma multiforme and refractory anaplastic astrocytoma. 

How is temozolomide dosed: The daily dose of temozolomide capsules for a given patient is usually calculated by the healthcare practitioner, based on the patient's body surface area (BSA). The resulting dose is then rounded off to around 5 mg.

The temozolomide dose for subsequent cycles can be adjusted according to nadir neutrophil as well as platelet counts in the previous cycle and during the time of starting the next cycle.

Treatment regimen: Temozolomide is recommended to be given for 5 consecutive days on a 28 day cycle. Patients need to continue taking temozolomide 20 mg until their healthcare practitioner determines that their disease has progressed, up to 22 months, or unt
il unacceptable adverse reactions or toxicities occur. 

How is temozolomide taken:

Patients should consume a daily dose with a full glass of water at about the same time every day. Taking the capsules on an empty stomach or at bedtime may help in order to ease the nausea. In case patients are also taking antinausea or other drugs to relieve the adverse reactions associated with temozolomide 5 mg, they are advised to take these drugs 30 minutes prior to taking temozolomide.

Apart from this, you may receive this drug by injection into a vein (intravenous). Your healthcare provider will decide the appropriate way for you to take this medicine. 

How is temozolomide capsules supplied: 

The drug temozolomide comes as capsules in 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, and temozolomide 100 mg strengths. The temozolomide capsules basically contain a white capsule body with the white cap.

Possible Side Effects: Common temozolomide side effects include:

• Nausea
• Vomiting
• Headache
• Feeling tired
• Hair loss 
• Constipation
• Bruising
• Rash
• Diarrhea
• Weakness
• Fever
• Dizziness
• Memory loss
• Loss of appetite
• Viral infection
• Sleep problems
• Coordination problems
• Infusion site reactions
• Paralysis on one side of the body

Tell your healthcare practitioner about any possible side effect that bothers you or that does not go away.

Who should not take this drug: Do not take Temodar in case you:

• have had an allergic reaction to DTIC (dacarbazine), another cancer drug.
• have had a red itchy rash, or a severe allergic reaction, such as trouble breathing, swelling of the face, throat, or tongue, or severe skin reaction to temozolomide injection or any of its ingredients. If you are not sure, ask your doctor. 

Precautions: Inform your healthcare practitioner about all your medical conditions, including:

• in case you are allergic to dacarbazine (DTIC) or have had a severe allergic reaction to temozolomide injection.
• in case you have kidney problems. 
• in case you have liver problems. 
• in case you are pregnant.
• in case you are breast-feeding. This drug may pass into breast milk. You and your doctor should take a decision if you will breast-feed or take temozolomide 100 mg. You must avoid doing both without interacting with your healthcare team.

Storage Guidelines: Store the capsules at 77°F (controlled room temperature). Storage at 15°C to 30°C is permitted occasionally. The temozolomide capsules should be placed out of the reach of children and pets.

How much does temozolomide cost? 

The temozolomide cost may vary from generic to innovator drugs. Prices may range from around 2050 INR to around 25000 INR. 

NOTE: The information provided in this article is only for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.