TEMOZOLOMIDE

Alkylating agent anticancer

Dosage Forms

Capsule

250 mg

Uses

  • Glioblastoma multiforme
  • Malignant glioma (brain cancer)

Dose and Duration

Glioblastoma multiforme (in combination with radiotherapy)

Adult: 75 mg/m² daily for 42 days (concomitant with focal radiotherapy); followed by up to 6 cycles of monotherapy at 150 mg/m² for 5 days every 4 weeks. Weekly haematological and non-haematological toxicity criteria determine dose continuation or escalation.

Glioblastoma multiforme (in previously untreated patients)

Adult and children > 3 years: 200 mg/m² once daily for the first 5 days followed by a 23 day treatment interruption.

In patients previously treated with chemotherapy: the initial dose is 150 mg/m² once daily, to be increased in the second cycle to 200 mg/m² once daily, for 5 days if there is no haematological toxicity.

Contra-indications

  • Children < 3 years
  • Hypersensitivity to temozolomide
  • Hypersensitivity to dacarbazine
  • Severe bone marrow suppression

Side Effects

  • Myelosuppression
  • Infections
  • Nausea and vomiting, anorexia, abdominal pain, stomatitis, constipation, diarrhoea
  • Rash, allergic reaction, fever, pain
  • Alopecia
  • Hyperglycaemia, weight loss
  • Hepatotoxicity; increased ALT
  • Anxiety, insomnia, depression
  • Headache, convulsions, blurred vision
  • Hearing impairment, tinnitus
  • Haemorrhage, oedema, thrombosis
  • Dyspnoea, coughing
  • Urinary frequency and incontinence
  • Muscle and joint pain
  • Fatigue

Interactions

  • Clozapine (increased risk of agranulocytosis)

Pregnancy

  • Do not use.

Breast-feeding

  • Discontinue breastfeeding.

⚠️ Caution

  • Monitor full blood count weekly.
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines.