Temozolomide Injection

(te moe zoe' loe mide)

Brand Name(s): , Temodar^®

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WHY is this medicine prescribed?

Temozolomide is used to treat certain types of brain tumors. Temozolomide is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Temozolomide injection comes as a powder to be added to fluid and injected over 90 minutes intravenously (into a vein) by a doctor or nurse. It is usually injected once a day. For some types of brain tumors, temozolomide is given daily for 42 to 49 days. Then, after a 28-day break, it may be given once a day for 5 days in a row, followed by a 23-day break before repeating the next dosage cycle. For treatment of other types of brain tumors, temozolomide is given once a day for 5 days in a row, followed by a 23-day break before repeating the next dosage cycle. The length of treatment depends on the how well your body responds to it and the type of cancer that you have.

Your doctor may need to delay your treatment or adjust your dose depending on your response to treatment and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment with temozolomide.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving temozolomide,

• tell your doctor and pharmacist if you are allergic to temozolomide, dacarbazine (DTIC-Dome) any other medications, or any of the ingredients in temozolomide injection. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: carbamazepine (Carbatrol, Epitol, Tegretol); co-trimoxazole (Bactrim, Septra); phenytoin (Dilantin, Phenytek); steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); and valproic acid (Stavzor, Depakene).
• tell your doctor if you have or have ever had kidney or liver disease.
• you should know that temozolomide may interfere with sperm production in men. However, you should not assume that you cannot get someone else pregnant. Tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are receiving temozolomide. Use a reliable method of birth control to prevent pregnancy. If you become pregnant while receiving temozolomide, call your doctor. Temozolomide may harm the fetus.
• tell your doctor if you are breast-feeding. You should not breastfeed while you are receiving temozolomide.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Temozolomide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• constipation
• loss of appetite
• sores in the mouth and throat
• headache
• pale skin
• lack of energy
• loss of balance or coordination
• fainting
• dizziness
• hair loss
• insomnia
• memory problems
• pain, itching, swelling, or redness in the place where the medication was injected
• changes in vision

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• unusual bleeding or bruising
• red or black, tarry stools
• pink, red, or dark brown urine
• coughing up or vomiting blood or material that looks like coffee grounds
• fever, sore throat, ongoing cough and congestion, or other signs of infection
• unusual tiredness or weakness
• rash
• unable to move one side of the body
• shortness of breath
• seizures
• yellowing of the skin or eyes
• pain in the upper right part of the stomach
• decreased urination

Temozolomide may increase the risk that you will develop other cancers. Talk to your doctor about the risks of taking temozolomide.

Temozolomide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ([WEB]) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at [WEB]. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• unusual bleeding or bruising
• red or black, tarry stools
• pink, red, or dark brown urine
• coughing up or vomiting blood or material that looks like coffee grounds
• fever, sore throat, ongoing cough and congestion, or other signs of infection

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order laboratory tests before, during, and after your treatment to check your body's response and to temozolomide to see if your blood cells are affected by this drug.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2023. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: February 15, 2013.