Posted on December 3rd, 2008 by
Generic Name: Dacarbazine, (day-KAR-be-zeen), DIC, DTIC, imidazole carboxamide
Trade Name: DTIC-Dome®
For which conditions is this drug approved? Dacarbazine is FDA approved for the treatment of metastatic melanoma and Hodgkin’s disease. It is also used for treatment of soft-tissue sarcomas, rhabdomyosarcoma, neuroblastoma, fibrosarcomas, islet cell carcinoma and medullary carcinoma of the thyroid. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Dacarbazine belongs to a group of drugs called alkylating agents. Dacarbazine produces its anti-cancer effects by causing a chemical reaction that damages the DNA in a cell. The DNA damage caused by dacarbazine inhibits protein synthesis and results in cellular death.
How is dacarbazine typically given (administered)? Dacarbazine is administered intravenously (into a vein) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient. During administration, if dacarbazine escapes from the vein that into the surrounding area, it has the potential to seriously damage tissues that it comes into contact with. Although patients will be closely monitored for this during administration, they should report any burning, redness or swelling near the administration site to a healthcare provider immediately.
How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with dacarbazine. Typically, blood will be drawn to monitor levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.
What are the common (occur in 30% or more of patients) side effects of treatment with dacarbazine?
• Low white blood cell levels – increases risk of infection
• Low red blood cell levels – increases risk of anemia and blood transfusions
• Low platelet levels – increases risk of bleeding
• Nausea and vomiting
• Loss of appetite
• Pain during drug administration
What are the less common (occur in 10% to 29% of patients) side effects of treatment with dacarbazine?
• Sensitivity to sunlight
• Flu-like symptoms (chills, fever, aches)
• Numbness of tingling of hands or feet
• Hair loss
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What are possible late side effects of treatment with dacarbazine? Some patients experience side effects months or years following treatment with dacarbazine. Uncommongly, patients may develop a secondary malignancy years following treatment with dacarbazine. A secondary malignancy is a new and unrelated cancer that occurs in an individual as a result of previous treatment with radiation or chemotherapy. Patients should ask their physician about the possibility of developing a secondary malignancy as a result of their treatment.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• Eat small meals frequently to help alleviate nausea.
• If patients have been prescribed an anti-nausea medication, they should be sure to take the prescribed doses.
• Patients need to protect themselves from exposure to sunlight. Wear light clothing, hats, sunglasses and sunscreen when outdoors.
Are there any special precautions patients should be aware of before starting chemotherapy?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
• Sore throat
• Flu or cold-like symptoms
• Excessive fatigue
• Numbness or tingling of hands or feet
• Pain, redness or swelling at the site of administration
• Prolonged or severe nausea or vomiting
• Severe or persistent fatigue
• Unexplained bleeding (nosebleeds, bruises, blood in urine, black tarry stools, etc.)
• Change in color of urine or stool
• Yellowing of skin or eyes
• Severe weight loss
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
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