Temozolomide Side Effects
Medically reviewed by Drugs.com. Last updated on Sep 10, 2023.
Applies to temozolomide: intravenous powder for solution. Other dosage forms:
Serious side effects of Temozolomide
Along with its needed effects, temozolomide 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 or nurse immediately if any of the following side effects occur while taking temozolomide:
More common
- Bladder pain
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody or cloudy urine
- body aches or pain
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest tightness
- chills
- cold or flu-like symptoms
- congestion
- cough or hoarseness
- difficult, burning, or painful urination
- difficulty with breathing
- dryness or soreness of the throat
- ear congestion
- fever
- frequent urge to urinate
- headache
- loss of ability to use or understand speech or language
- loss of bladder control
- loss of voice
- lower back or side pain
- pain or tenderness around the eyes and cheekbones
- partial or slight paralysis
- rapid weight gain
- seizures
- shakiness and unsteady walk
- sneezing
- sore throat
- stuffy or runny nose
- tender, swollen glands in the neck
- tingling of the hands or feet
- trouble swallowing
- troubled breathing
- unsteadiness, trembling, or other problems with muscle control or coordination
- unusual tiredness or weakness
- unusual weight gain or loss
- voice changes
Less common
- Black, tarry stools
- bleeding gums
- dizziness
- fast heartbeat
- flushing or redness of the skin
- hives, itching, or skin rash
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- unusual bleeding or bruising
- unusually warm skin
Incidence not known
- Blistering, peeling, or loosening of the skin
- clay colored stools
- decreased appetite
- deep, dark purple bruise
- diarrhea
- joint or muscle pain
- nausea or vomiting
- red skin lesions, often with a purple center
- red, irritated eyes
- small red or purple spots on the skin
- sores, ulcers, or white spots in the mouth or on the lips
- stomach pain or tenderness
- yellow eyes or skin
Other side effects of Temozolomide
Some side effects of temozolomide 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
- Back pain
- being forgetful
- blurred vision
- breast pain
- change in walking and balance
- clumsiness or unsteadiness
- constipation
- discouragement
- fear or nervousness
- feeling sad or empty
- hair loss or thinning of the hair
- irritability
- lack or loss of strength
- loss of interest or pleasure
- problems with memory
- sleepiness or unusual drowsiness
- tiredness
- trouble concentrating
- trouble sleeping
- weight loss
Less common
- Change in taste or bad unusual or unpleasant (after) taste
- changes in vision
- difficulty with moving
- double vision
- dry skin
- increased weight
- mood or mental changes
- muscle aching or cramping
- muscle stiffness
- seeing double
- swollen joints
Incidence not known
- Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
For Healthcare Professionals
Applies to temozolomide: intravenous powder for injection, oral capsule.
Gastrointestinal
Very common (10% or more): Constipation (Up to 33%), nausea (Up to 53%), vomiting (Up to 42%), diarrhea (16%)
Common (1% to 10%): Abdominal pain, diarrhea, stomatitis, taste perversion, dysphagia, dyspepsia
Uncommon (0.1% to 1%): Abdominal distension, fecal incontinence, gastrointestinal disorder, gastroenteritis, hemorrhoids[Ref]
General
The most common side effects were alopecia, nausea, vomiting, anorexia, headache, and constipation.[Ref]
Nervous system
Very common (10% or more): Headache (Up to 41%), convulsions (Up to 23%), hemiparesis (18%), abnormal coordination (11%)
Common (1% to 10%): Dizziness, confusion, memory impairment, amnesia, paresthesia, somnolence, paresis, urinary incontinence, ataxia, abnormal gait, neuropathy, balance impairment, speech disorder, tremors, hemiparesis[Ref]
Cardiovascular
Very common (10% or more): Peripheral edema (11%)
Uncommon (0.1% to 1%): Palpitation[Ref]
Other
Very common (10% or more): Fatigue (Up to 61%), asthenia (13%), fever (13%)
Common (1% to 10%): Weakness, radiation injury, face edema, pain, hearing impairment
Uncommon (0.1% to 1%): Otitis media, tinnitus, hyperacusis, earache, deafness, vertigo, impotence, vaginal hemorrhage, menorrhagia, amenorrhea, vaginitis, breast pain[Ref]
Endocrine
Common (1% to 10%): Adrenal hypercorticism[Ref]
Respiratory
Common (1% to 10%): Cough, dyspnea, upper respiratory tract infection, pharyngitis, sinusitis
Post-marketing surveillance: Interstitial pneumonitis, pneumonitis, alveolitis, pulmonary fibrosis[Ref]
Dermatologic
Very common (10% or more): Alopecia (55 to 69%), rash (13 to 19%)
Common (1% to 10%): Dry skin, erythema, pruritus, petechiae
Uncommon (0.1% to 1%): Photosensitivity reaction, abnormal pigmentation, sweating increased
Post-marketing surveillance: Toxic epidermal necrolysis, Stevens-Johnson syndrome[Ref]
A case of diffuse erythematous skin rash that progressed to an extensive full body desquamative skin rash has been reported. Even though temozolomide was permanently discontinued, the patient continued to experience the rash on a long-term basis with periodic exacerbations.[Ref]
Psychiatric
Common (1% to 10%): Insomnia, anxiety, depression
Uncommon (0.1% to 1%): Agitation, apathy, behavior disorder, hallucination, amnesia[Ref]
Metabolic
Very common (10% or more): Anorexia (19 to 27%)
Common (1% to 10%): Weight increase, weight decrease, hyperglycemia
Uncommon (0.1% to 1%): Hypokalemia[Ref]
Musculoskeletal
Common (1% to 10%): Arthralgia, back pain[Ref]
Ocular
Common (1% to 10%): Vision blurred, diplopia
Uncommon (0.1% to 1%): Hemianopia, visual acuity reduced, vision disorder, visual field defect, eye pain, dry eyes[Ref]
Immunologic
Common (1% to 10%): Infection, Herpes simplex, wound infection, candidiasis oral
Uncommon (0.1% to 1%): Herpes zoster, influenza-like symptoms
Post-marketing surveillance: Opportunistic infections including Pneumocystis pneumonia[Ref]
Oncologic
Post-marketing surveillance: Secondary malignancies including myeloid leukemia[Ref]
Hematologic
Common (1% to 10%): Thrombocytopenia, hemorrhage, leukopenia, neutropenia, lymphopenia, febrile neutropenia, anemia
Post-marketing surveillance: Prolonged pancytopenia, myelodysplastic syndrome[Ref]
Hepatic
Common (1% to 10%): ALT increased
Uncommon (0.1% to 1%): Hepatic enzymes increased, Gamma GT increased, AST increased
Post-marketing surveillance: Fatal and severe hepatotoxicity, elevation of liver enzymes, hyperbilirubinemia, cholestasis, hepatitis
Hypersensitivity
Common (1% to 10%): Allergic reaction
Renal
Common (1% to 10%): Urinary tract infection, micturition increased frequency
Uncommon (0.1% to 1%): Dysuria
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References
1. Product Information. Temodar (temozolomide). Schering Corporation. 2001;PROD.
2. Pick AM, Neff WJ, Nystrom KK. Temozolomide-induced desquamative skin rash in a patient with metastatic melanoma. Pharmacotherapy. 2008;28:406-9.
3. Villano JL, Collins CA, Manasanch EE, Ramaprasad C, van Besien K. Aplastic anaemia in patient with glioblastoma multiforme treated with temozolomide. Lancet Oncol. 2006;7:436-8.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.