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Dacogen

Generic Name: decitabine (de SIT a been)
Brand Names: Dacogen

Medically reviewed by P. Thornton, DipPharm. Last updated on Dec 13, 2018.

What is Dacogen?

Dacogen (decitabine) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Dacogen injection is used to treat myelodysplastic syndromes (certain types of blood or bone marrow cancer).

Dacogen may also be used for purposes not listed in this medication guide.

Important Information

Dacogen affects your immune system. You may get infections more easily. Call your doctor if you have unusual bruising or bleeding, or new signs of infection (fever, chills, cough, sore throat, trouble breathing).

Before receiving a Dacogen injection, tell your doctor if you have liver or kidney disease.

Do not use Dacogen if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. If a man fathers a child while using Dacogen, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment. Continue using condoms for at least 2 months after you stop receiving this medicine. You should not breast-feed while you are receiving this medicine.

Before taking this medicine

To make sure you can safely take Dacogen, tell your doctor if you have ever had:

Decitabine can harm an unborn baby or cause birth defects if the mother or the father is using this medicine.

  • If you are a woman, do not use decitabine if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 1 month after your last dose.

  • If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 2 months after your last dose.

  • Tell your doctor right away if a pregnancy occurs while either the mother or the father is using Dacogen.

You should not breast-feed while using Dacogen.

How is Dacogen given?

Dacogen injection is given as an infusion into a vein. A healthcare provider will give you this injection.

In most cases, a Dacogen injection is given every 8 hours for 3 days. This 3-day treatment is usually repeated every 6 weeks at least 4 times.

You may be given other medications to prevent nausea or vomiting while you are receiving Dacogen.

Dacogen affects your immune system. You may get infections more easily. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

Dacogen dosing information

Usual Adult Dose for Myelodysplastic Syndrome:

TREATMENT REGIMEN OPTION 1:
15 mg/m2 IV over 3 hours; repeat every 8 hours for 3 days; repeat this cycle every 6 weeks; patients may be premedicated with standard antiemetic therapy

If hematologic recovery (ANC 1,000/mcL or greater and platelets 50,000/mcL or greater) from a previous treatment cycle requires more than 6 weeks, then the next cycle should be delayed and dosing temporarily reduced by following this algorithm:
-Recovery requiring more than 6, but less than 8 weeks: Delay dosing for up to 2 weeks and temporarily reduce the dose to 11 mg/m2 IV every 8 hours (33 mg/m2/day, 99 mg/m2/cycle) when restarting therapy
-Recovery requiring more than 8, but less than 10 weeks: Assess patient for disease progression (by bone marrow aspirates); in the absence of progression, the dose should be delayed up to 2 more weeks and then reduced to 11 mg/m2 IV every 8 hours (33 mg/m2/day, 99 mg/m2/cycle) when restarting therapy, then maintained or increased in subsequent cycles as clinically indicated

TREATMENT REGIMEN OPTION 2:
20 mg/m2 IV over 1 hour; repeat daily for 5 days; repeat this cycle every 4 weeks; patients may be premedicated with standard antiemetic therapy

If myelosuppression is present, subsequent treatment cycles should be delayed until there is hematologic recovery (ANC 1,000/mcL or greater and platelets 50,000/mcL or greater)

Comments:
-With either regimen, it is recommended that patients be treated for a minimum of 4 cycles; however, a complete or partial response may take longer than 4 cycles.
-Perform complete blood and platelet counts prior to each cycle and as needed to monitor response and toxicity.
-Perform liver chemistries and serum creatinine prior to initiation of therapy.

Use: For the treatment of myelodysplastic syndromes (MDS) including previously treated and untreated, de novo and secondary MDS of all French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia) and intermediate-1, intermediate-2, and high-risk International Prognostic Scoring System groups

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Dacogen injection.

What happens if I overdose?

Since Dacogen is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving Dacogen?

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). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. 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.

Dacogen side effects

Get emergency medical help if you have signs of an allergic reaction to Dacogen: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, chills, body aches, cough, sore throat, flu symptoms;

  • easy bruising, unusual bleeding, purple or red spots under your skin;

  • pale skin, cold hands and feet;

  • slow heart rate, weak pulse, slow breathing; or

  • cough with mucus, chest pain, feeling short of breath.

Common Dacogen side effects may include:

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 Dacogen?

Other drugs may interact with decitabine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Dacogen only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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