Details

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Temozolomide 20mg, 100mg, 250mg Capsules is a cell cycle non specific (CCNS)  anticancer drug belonging to alkylating agents.

It is better than dacarbazine as it metabolises at physiological pH and does not require specific enzymes.

It can cross the blood brain barrier therefore used in brain tumors.

Mechanism of action:it acts bio transforming itself  into an active metabolite methyl triazine imidazole carboxamide (MTIC) that alkylate the DNA molecule resulting in non functional DNA.It also inhibits DNA repair enzyme alkyltransferase. All this leads to inhibition of DNA function and synthesis.

It is available as Temodal & Temodar in International and as Temodal in Indian markets.

 

Uses

• Temozolomide 20mg, 100mg, 250mg Capsules is indicated in glioblastoma multiforme (GBM) along with radiotherapy and maintenance therapy.
• Temodal is used in Refractory anaplastic astrocytoma patients.
• It is also used in metastatic melanoma.

 

Dosage

• Temozolomide 20mg, 100mg, 250mg Capsules Comes as white opaque bodies with yellow ,pink and white caps respectively.
• Final dosages are determined by the doctor on the basis of factors such as medical condition, age, weight and ongoing medications.
• Dose is adjusted to minimise related side effects.
• Temodal must be taken on an empty stomach or at bedtime to reduce nausea and vomiting side effects.
• Recommended dose of Temodal for GBM is 75 mg/m2 for 42 days & 150 mg/m2 daily for Days 1-5 of a 28-day cycle as maintenance therapy and for Refractory Anaplastic Astrocytoma is 150 mg/m2 daily for 5 consecutive days per 28-day treatment cycle.

 

Side effects

• Headache
• Fever
• Fatigue
• Myelosuppression – lymphopenia, thrombocytopenia, neutropenia, leukopenia
• Nausea and vomiting
• Photosensitivity
• Allergic reactions
• Elevation in liver function tests
• Hair loss
• Constipation
• Anorexia
• Convulsions
• Rash
• Hemiparesis
• Diarrhea
• Asthenia
• Dizziness
• Abnormal Coordination
• Viral infection
• Amnesia
• Insomnia
• Myelodysplastic syndrome
• Secondary malignancies like myeloid leukemia

 

Precautions

• Temozolomide 20mg, 100mg, 250mg Capsules is contraindicated in case of hypersensitivity to temozolomide or history of allergy to
• Valproic acid interacts with decreases the efficacy of temozolomide.
• Prophylaxis against Pneumocystis pneumonia and Antiemetic therapy is required to treat drug related side effects.
• Complete blood count, liver and kidney function tests are necessary.
• Careful monitoring in cases of severe renal and hepatic impairment is required  especially in females and older patients.
• Temodar is not recommended in pregnant women as it causes damage to the fetus.
• Tell the doctor about ongoing medications and any allergy before starting the drug.

Always tell the doctor about pregnancy or future plan of pregnancy or breastfeeding.