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Azacitidine Dosage

Medically reviewed by Drugs.com. Last updated on Oct 9, 2023.

Applies to the following strengths: 100 mg; 200 mg; 300 mg

Usual Adult Dose for Myelodysplastic Syndrome

PARENTERAL:
FIRST TREATMENT CYCLE: 75 mg/m2 IV or subcutaneously daily for 7 days, repeat cycles every 4 weeks
SUBSEQUENT CYCLES: After 2 cycles, may increase dose to 100 mg/m2 if no beneficial effect is seen and if no toxicity other than nausea and vomiting has occurred

DURATION OF THERAPY:
Parenteral: Minimum of 4 to 6 cycles, may continue treatment if the patient continues to benefit.

Comments:


Use: Treatment of patients with the following French-American-British (FAB) myelodysplastic syndrome (MDS) subtypes: refractory anemia (RA) or refractory anemia with ringed sideroblasts (RARS) if accompanied by neutropenia or thrombocytopenia or requiring transfusions, refractory anemia with excess blasts (RAEB), refractory anemia with excess blasts in transformation (RAEB-T), and chronic myelomonocytic leukemia (CMMoL)

Usual Adult Dose for Acute Myeloid Leukemia

ORAL:
300 mg orally once daily for 14 days in a 28-day cycle

DURATION OF THERAPY: Until disease progression or unacceptable toxicity.

Comments:


Use: Treatment of adult patients with acute myeloid leukemia who achieved first complete remission (CR) or complete remission with incomplete blood count recovery (CRi) following intensive induction chemotherapy and are not able to complete intensive curative therapy

Usual Pediatric Dose for Leukemia

1 month to less than 1 year or weighing less than 10 kg:
2.5 mg/kg IV or subcutaneously daily for 7 days in a 28-day cycle

1 year and older and weighing 10 kg or greater:
75 mg/m2 IV or subcutaneously daily for 7 days in a 28-day cycle

Duration of therapy: 3 to 6 cycles.

Comments:


Use: Treatment of pediatric patients aged one month and older with newly diagnosed Juvenile Myelomonocytic Leukemia (JMML)

Renal Dose Adjustments

Unexplained reductions in serum bicarbonate levels to less than 20 mEq/L: Reduce dose by 50% for the next course.
Unexplained elevations of BUN or serum creatinine: Delay the next cycle until values return to normal or baseline and reduce dose by 50% for the next course.

Liver Dose Adjustments

Patients with severe preexisting hepatic impairment are at higher risk for toxicity.
Advanced malignant hepatic tumors: Use is contraindicated.
Oral tablet formulation: No dose adjustment is recommended for patients with mild hepatic impairment.

Dose Adjustments

Parenteral:
Adults:
Baseline WBC 3 x 10(9)/L or greater, absolute neutrophil count (ANC) 1.5 x 10(9)/L or greater, AND platelets 75 x 10(9)/L or greater:


Baseline WBC less than 3 x 10(9)/L, ANC less than 1.5 x 10(9)/L, OR platelets less than 75 x 10(9)/L, base dose adjustments on nadir counts and bone marrow biopsy cellularity at the time of the nadir unless there is clear improvement in differentiation (percentage of mature granulocytes is higher and ANC is higher than at onset of that course) at the time of the next cycle, in which case continue the current dose:
BASELINE WBC less than 3 x 10(9)/L, ANC less than 1.5 x 10(9)/L, OR platelets less than 75 x 10(9)/L AND WBC or platelet nadir 50% to 75% decrease in counts from baseline:
BASELINE WBC less than 3 x 10(9)/L, ANC less than 1.5 x 10(9)/L, OR platelets less than 75 x 10(9)/L AND WBC or platelet nadir greater than 75% decrease in counts from baseline:

Pediatric:

Based on Serum Electrolytes and Renal Toxicity:

Oral:
Adult:
Myelosuppression:

Gastrointestinal toxicity:


Other Adverse Reactions:
Grade 3 or 4:

Precautions

CONTRAINDICATIONS:



Consult WARNINGS section for additional precautions.

Dialysis

Data not available.

Other Comments

Administration advice:


Storage requirements:
Vials:

Tablets:

Reconstitution:
Subcutaneous:

Intravenous:

General:

Monitoring:

Patient Advice:

Further information

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