Dacarbazine

What is Dacarbazine?

• Dacarbazine is a triazene analogue of 5-aminoimidazole-4-carboxamide, a precursor in purine biosynthesis used to treat Hodgkin lymphoma that did not get better with other anticancer drugs. It is also used to treat melanoma that has spread to other parts of the body.

Dacarbazine

Dacarbazine ball-and-stick

Dacarbazine2DACS

What are the uses of this medicine?

Dacarbazine is approved to be used alone or with other drugs to treat:

• Hodgkin lymphoma in patients whose disease has not gotten better with other chemotherapy.
• Melanoma that has metastasized (spread to other parts of the body).

How does this medicine work?

• Dacarbazine (da kar' ba zeen) is a triazene analogue of 5-aminoimidazole-4-carboxamide, a precursor in purine biosynthesis.
• Its mechanism of action in cancer chemotherapy is unclear.
• Dacarbazine may act as a purine analogue and antimetabolite.
• In addition, it is extensively metabolized in the liver and produces intermediates some of which have alkylating activity, causing methylation, modification and cross linking of DNA, thus inhibiting DNA, RNA and protein synthesis.

Who Should Not Use this medicine ?

This medicine cannot be used in patients:

• who have demonstrated a hypersensitivity to it.

What drug interactions can this medicine cause?

• No formal drug interaction studies have been conducted with Dacarbazine.

Is this medicine FDA approved?

• Dacarbazine is popularly known as DTIC and was approved for use in the United States in 1975.
• Current indications include Hodgkin lymphoma and metastatic malignant melanoma usually in combination with other antineoplastic agents.

How should this medicine be used?

Recommended dosage: Malignant Melanoma:

• The recommended dosage is 2 to 4.5 mg/kg/day for 10 days. Treatment may be repeated at 4 week intervals.
• An alternate recommended dosage is 250 mg/square meter body surface/day intravenous for 5 days. Treatment may be repeated every 3 weeks.

Hodgkin's Disease:

• The recommended dosage of dacarbazine for injection in the treatment of Hodgkin's Disease is 150 mg/square meter body surface/day for 5 days, in combination with other effective drugs.
• Treatment may be repeated every 4 weeks.
• An alternative recommended dosage is 375 mg/square meter body surface on day 1, in combination with other effective drugs, to be repeated every 15 days.

Administration:

• Dacarbazine injection comes as a powder to be mixed with liquid to be injected intravenously (into a vein) over 1 minute or infused intravenously over 15 to 30 minutes by a doctor or nurse in a medical facility.
• When dacarbazine is used to treat melanoma, it may be injected once a day for 10 days in a row every 4 weeks or it may be injected once a day for 5 days in a row every 3 weeks.
• When dacarbazine is used to treat Hodgkin's lymphoma is may be injected once a day for 5 days in a row every 4 weeks or it may be injected once every 15 days.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Injection vial contains 200 mg of dacarbazine

This medicine is available in fallowing brand namesː

• DTIC-Dome

What side effects can this medication cause?

The most common side effects of this medicine include:

• nausea
• vomiting
• loss of appetite
• diarrhea
• sores in the mouth and throat
• hair loss
• feeling of burning or tingling on the face
• flushing
• flu-like symptoms

Dacarbazine can cause serious side effects including:

• bone marrow suppression
• neutropenia
• sepsis
• embryo-fetal toxicity
• de novo carcinogenesis

What special precautions should I follow?

• Hemopoietic depression is the most common toxicity with dacarbazine for injection and involves primarily the leukocytes and platelets, although anemia may sometimes occur. The possible bone marrow depression requires careful monitoring of white blood cells, red blood cells, and platelet levels.
• Hepatic toxicity accompanied by hepatic vein thrombosis and hepatocellular necrosis resulting in death, has been reported.
• Anaphylaxis can occur following the administration of dacarbazine for injection.
• Extravasation of the drug subcutaneously during intravenous administration may result in tissue damage and severe pain. Local pain, burning sensation, and irritation at the site of injection may be relieved by locally applied hot packs.
• Dacarbazine may cause serious or life-threatening liver damage. Liver damage may occur more often in people that are receiving other cancer chemotherapy drugs along with dacarbazine treatment.
• Dacarbazine injection must be given in a hospital or medical facility under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.

What to do in case of emergency/overdose?

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Management of overdosage:

• Give supportive treatment and monitor blood cell counts.

Can this medicine be used in pregnancy?

• There are no adequate and well controlled studies in pregnant women.
• Dacarbazine for injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• DACARBAZINE

Inactive ingredients:

• ANHYDROUS CITRIC ACID
• MANNITOL

Who manufactures and distributes this medicine?

Distributed by:

• Teva Pharmaceuticals USA, Inc.
• Parsippany, NJ

What should I know about storage and disposal of this medication?

• Store in a refrigerator 2° to 8°C (36° to 46°F).
• Use within 8 hours of reconstitution.
• Protect from light.
• Discard Unused Portion.

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• Dailymed label info on Dacarbazine
• FDA Dacarbazine