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dacarbazine (Intravenous route, Injection route)

da-KAR-ba-zeen

Intravenous route(Powder for Solution)

Hemopoietic depression is the most common toxicity with dacarbazine for injection. Hepatic necrosis has also been reported. Studies have demonstrated this agent to have a carcinogenic and teratogenic effect when used in animals .

Commonly used brand name(s)

In the U.S.

  • Dtic-Dome

In Canada

  • Dacarbazine

Available Dosage Forms:

  • Powder for Solution
  • Powder for Suspension

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Alkylating Agent

Chemical Class: Imidazole Carboxamide

Uses For dacarbazine

Dacarbazine belongs to the group of medicines called alkylating agents. It is used to treat cancer of the lymph system and malignant melanoma (a type of skin cancer). It may also be used to treat other kinds of cancer, as determined by your doctor.

Dacarbazine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by dacarbazine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

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Before you begin treatment with dacarbazine, you and your doctor should talk about the good dacarbazine will do as well as the risks of using it.

Dacarbazine is to be administered only by or under the immediate supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, dacarbazine is used in certain patients with the following medical conditions:

  • Cancer of the islet cells (a part of the pancreas)
  • Soft tissue sarcomas (a cancer of the muscles, tendons, vessels that carry blood or lymph, joints, and fat)

Before Using dacarbazine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dacarbazine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to dacarbazine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on dacarbazine have been done only in adult patients and there is no specific information comparing use of dacarbazine in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information about the use of dacarbazine in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dacarbazine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using dacarbazine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live

Using dacarbazine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine

Using dacarbazine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aldesleukin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of dacarbazine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
  • Infection—Dacarbazine can decrease your body's ability to fight infection
  • Kidney disease or
  • Liver disease—Effects of dacarbazine may be increased because of slower removal from the body

Proper Use of dacarbazine

Dacarbazine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to remember to take them at the right times.

dacarbazine often causes nausea, vomiting, and loss of appetite. The injection may also cause a feeling of burning or pain. However, it is very important that you continue to receive the medicine, even if you have discomfort or begin to feel ill. After 1 or 2 days, your stomach upset should lessen. Ask your health care professional for ways to lessen these effects.

Dosing

The dose of dacarbazine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dacarbazine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using dacarbazine

It is very important that your doctor check your progress at regular visits to make sure that dacarbazine is working properly and to check for unwanted effects.

While you are being treated with dacarbazine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Dacarbazine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Dacarbazine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

If dacarbazine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

dacarbazine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Redness, pain, or swelling at place of injection
Less common
  • Black, tarry stools
  • blood in urine or stools
  • cough or hoarseness, accompanied by fever or chills
  • fever or chills
  • lower back or side pain, accompanied by fever or chills
  • painful or difficult urination, accompanied by fever or chills
  • pinpoint red spots on skin
  • unusual bleeding or bruising
Rare
  • Shortness of breath
  • stomach pain
  • swelling of face
  • yellow eyes or skin

Check with your doctor as soon as possible if any of the following side effects occur:

Rare
  • Sores in mouth and on lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Loss of appetite
  • nausea or vomiting (should lessen after 1 or 2 days)
Less common
  • Feelings of uneasiness
  • flushing of face
  • muscle pain
  • numbness of face

dacarbazine may cause a temporary loss of hair in some people. After treatment with dacarbazine has ended, normal hair growth should return.

After you stop using dacarbazine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

  • Black, tarry stools
  • blood in urine or stools
  • cough or hoarseness, accompanied by fever or chills
  • fever or chills
  • lower back or side pain, accompanied by fever or chills
  • painful or difficult urination, accompanied by fever or chills
  • pinpoint red spots on skin
  • unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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