What is the most important information I should know about temozolomide?
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
What is temozolomide?
Temozolomide is a cancer medicine that interferes with the growth and spread of cancer cells in the body.
Temozolomide is used together with radiation therapy to treat certain types of brain tumor in adults.
Temozolomide is usually given after other cancer medicines have been tried without success.
Temozolomide may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking temozolomide?
You should not take this medicine if you are allergic to temozolomide or to another cancer medication called dacarbazine (DTIC).
To make sure temozolomide is safe for you, tell your doctor if you have:
- liver disease; or
- kidney disease.
Using temozolomide may increase your risk of developing certain types of bone marrow cancer. Ask your doctor about your specific risk.
Do not use temozolomide if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.
This medicine may affect fertility in men. Talk to your doctor about your own risk.
It is not known whether temozolomide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take temozolomide?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Temozolomide is given in a 28-day treatment cycle, and you may only need to take the medicine during the first few days of each cycle.
If you are also receiving radiation treatment, you may need to take temozolomide for 6 to 7 weeks in a row during your first treatment cycle. Then you may be switched to a 28-day maintenance treatment cycle.
Your doctor will determine how long to treat you with temozolomide. Follow your doctor's dosing instructions very carefully.
Your doctor may occasionally change your dose to make sure you get the best results. The size, color, and number of temozolomide capsules you take may sometimes be different from earlier treatment cycles. Be sure you know the correct number of capsules to take and on which days to take them. Ask your doctor or pharmacist if you have any questions.
Take all of your capsules for the day (one entire daily dose) at the same time on each dosing day of a treatment cycle. Swallow the capsules whole with a full glass of water.
Take this medicine at the same time each day.
You may need to take temozolomide at bedtime or on an empty stomach if the medicine upsets your stomach.
If you vomit shortly after taking the medicine, do not take another capsule until your next regularly scheduled dose.
Do not open the temozolomide capsule. Do not use a broken pill. The medicine from an open or broken capsule can be dangerous if it gets in your mouth or nose, or on your skin. If this occurs, rinse thoroughly with water. Ask your doctor or pharmacist how to safely handle and dispose of a broken tablet or capsule.
You may be given medication to prevent nausea or other side effects while you are receiving temozolomide.
Tell your doctor if you have any changes in height or weight. Temozolomide doses are based on body surface area (height and weight), and any changes may affect your dose.
Temozolomide can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.
You may also need blood tests to check your liver function during treatment and for 2 to 4 weeks after you stop using this medicine.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Call your doctor for instructions if you miss a dose of temozolomide.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking temozolomide?
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
What are the possible side effects of temozolomide?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a seizure (convulsions);
- sudden chest pain or discomfort, wheezing, dry cough, feeling short of breath;
- easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
-
low white blood cell counts --fever, swollen gums, painful mouth sores, skin sores, cold or flu symptoms, cough, trouble breathing; or
-
liver problems --nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Common side effects may include:
- nausea, vomiting, loss of appetite;
- bruising, skin rash;
- loss of movement on one side of the body;
- diarrhea, constipation;
- headache, tired feeling, memory problems;
- dizziness, weakness, loss of coordination;
- sleep problems (insomnia);
- low white blood cell counts (fever, flu symptoms); or
- hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect temozolomide?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with temozolomide, especially:
- steroid medicine (dexamethasone, prednisone, and others); or
- valproic acid (Depakene, Stavzor).
This list is not complete. Other drugs may interact with temozolomide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your pharmacist can provide more information about temozolomide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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