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Class: Antineoplastic Agents
VA Class: AN300
CAS Number: 4342-03-4
Brands: DTIC-Dome

Medically reviewed by Last updated on June 10, 2020.


  • Use under supervision of a qualified clinician experienced in therapy with antineoplastic agents.100 Carefully weigh risks/benefits of therapy in each patient.100

  • Myelosuppression occurs commonly.100 (See Hematologic Effects under Cautions.)

  • Hepatic necrosis reported.100 (See Hepatic Effects under Cautions.)

  • Known carcinogen and teratogen in animals.100 (See Carcinogenicity and also Fetal/Neonatal Morbidity and Mortality, under Cautions.)


Antimetabolite antineoplastic agent; a purine analog.100

Uses for Dacarbazine


A systemic treatment of choice for the palliative treatment of metastatic melanoma.100 101 105 106 107 108 111 135 138 Has been used alone and in combination regimens.105 106 107 108 111 135 Optimal regimen remains to be established.105 107 138

Hodgkin’s Disease

Treatment of advanced Hodgkin’s disease in combination with other antineoplastic agents.100 101 102 103 104 Often used with doxorubicin, bleomycin, and vinblastine (ABVD regimen).101 102 103 104

Dacarbazine Dosage and Administration


  • Consult specialized references for procedures for proper handling and disposal of antineoplastic drugs.100


IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

Administer only by IV injection or infusion.100 b Extremely irritating to tissues; avoid extravasation.100 (See Local Effects under Cautions.)


Reconstitute vial containing 100 or 200 mg of dacarbazine powder with 9.9 or 19.7 mL, respectively, of sterile water for injection to provide a solution containing 10 mg/mL.100 c d


Reconstituted solution may be further diluted with 5% dextrose or 0.9% sodium chloride injection and infused IV.100 c d

Rate of Administration

IV injection: Administer over 1 minute.100 b

IV infusion: Infuse diluted solution over 15–30 minutes.100 b


Optimize results and minimize adverse effects by basing dose on clinical and hematologic response, patient tolerance, and other chemotherapy or irradiation being used.100 b

Consult published protocols for dosages in combination regimens and method and sequence of administration.b


Metastatic Melanoma

2–4.5 mg/kg daily for 10 days; may repeat at 4-week intervals.100

Alternatively, 250 mg/m2 daily for 5 days; may repeat at 3-week intervals.100

Hodgkin’s Disease

150 mg/m2 daily for 5 days in combination with other antineoplastic agents; may repeat every 4 weeks.100

Alternatively, 375 mg/m2 on day 1, in combination with other antineoplastic agents; repeat every 15 days.100

Cautions for Dacarbazine


  • Hypersensitivity to dacarbazine or any ingredient in the formulation.100



Administer only under supervision of a qualified clinician experienced in therapy with antineoplastic agents.100 (See Boxed Warning.)

Hematologic Effects

Myelosuppression (principally severe leukopenia and thrombocytopenia) occurs commonly, generally 2–4 weeks after the last dose;100 b fatal leukopenia and thrombocytopenia reported.100 Anemia can occur.100 b

Carefully monitor hematologic status during therapy; evaluate leukocyte, erythrocyte, and platelet counts at frequent intervals.100

Hematopoietic toxicity (generally leukocyte count <3000/mm3 and platelet count <100,000/mm3) may require temporary withdrawal or discontinuance of the drug.100 b

Hepatic Effects

Hepatotoxicity complicated by hepatic vein thrombosis and hepatocellular necrosis resulting in death has been reported.100 More common with combination regimens but also occurs with dacarbazine alone.100

Fetal/Neonatal Morbidity and Mortality

May cause fetal harm; teratogenicity and embryolethality demonstrated in animals.100

Sensitivity Reactions

Hypersensitivity Reactions

Possible hypersensitivity reactions, including anaphylaxis.100


Photosensitivity reactions reported rarely.100

General Precautions


Carcinogenic effects reported in animals; importance in humans not known.100 b

Local Effects

Extravasation may result in tissue damage and severe pain.100

Undiluted solutions administered by IV injection may cause severe pain and phlebitis; some clinicians recommend dilution and infusion.b

Hot packs may relieve local pain, burning sensation, and irritation at the injection site.100

Specific Populations


Category C.100


Not known whether dacarbazine is distributed into milk; discontinue nursing or the drug.100

Common Adverse Effects

Anorexia, nausea, vomiting, leukopenia, thrombocytopenia.100

Interactions for Dacarbazine

Metabolized by hepatic microsomal enzymes.b

Drugs Affecting Hepatic Microsomal Enzymes

Enzyme inducers: Possible increased metabolism of dacarbazine.b

Specific Drugs




Possible increased dacarbazine metabolismb


Possible increased dacarbazine metabolismb

Dacarbazine Pharmacokinetics



Poorly absorbed from the GI tract.b



Volume of distribution exceeds total body water content, suggesting localization in a body tissue, probably the liver.100

Crosses blood-brain barrier to a limited extent; CSF concentrations approximately 14% of plasma concentrations.100

Not known whether dacarbazine crosses the placenta or is distributed into milk.100

Plasma Protein Binding

Slightly bound.100



Extensively metabolized; hepatic microsomal enzymes are involved.100 b Some metabolites may contribute to the antineoplastic effect of the drug.b

Elimination Route

Excreted in urine by tubular secretion; about 46% of an administered dose is excreted in urine within 6 hours (about 50% as unchanged drug and 50% as 5-amino-1H-imidazole-4-carboxamide [AIC]). (See Actions.)100 b


Biphasic; initial-phase half-life averages 19 minutes; terminal half-life averages 5 hours.100




Powder for Injection

2–8°C; protect from light.100

Use reconstituted solutions containing 10 mg/mL in sterile water for injection within 8 hours if stored at room temperature or 72 hours if stored at 4°C.100 d

Use solutions further diluted with ≤500 mL of 5% dextrose or 0.9% sodium chloride injection within 8 hours if stored at room temperature or 24 hours if stored at 4°C.100 b d


For information on systemic interactions resulting from concomitant use, see Interactions.


Solution Compatibility


Dextrose 5% in waterHID

Sodium chloride 0.9%b

Drug Compatibility
Admixture CompatibilityHID


Ondansetron HCl


Ondansetron HCl with doxorubicin HCl


Hydrocortisone sodium succinateb

Y-Site CompatibilityHID




Doxorubicin HCl liposome injection

Etoposide phosphate


Fludarabine phosphate

Granisetron HCl

Melphalan HCl

Ondansetron HCl


Palonosetron HCl




Vinorelbine tartrate


Allopurinol sodium

Hydrocortisone sodium succinate

Piperacillin sodium–tazobactam sodium


Heparin sodium


  • Appears to exert cytotoxic effect by acting as an alkylating agent.100

  • Does not exhibit cell cycle-phase specificity.b

  • Synthetic analog of naturally occurring purine precursor 5-amino-1H-imidazole-4-carboxamide (AIC).100

Advice to Patients

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.100

  • Importance of informing patients of other important precautionary information. (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name



Dosage Forms


Brand Names



For injection, for IV use

100 mg*

Dacarbazine for Injection

200 mg*

Dacarbazine for Injection



AHFS DI Essentials™. © Copyright 2021, Selected Revisions June 20, 2013. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.


Only references cited for selected revisions after 1984 are available electronically.

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HID. Trissel LA. Handbook on injectable drugs. 17th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2013:327-9.

b. AHFS Drug Information 2004. McEvoy GK, ed. Dacarbazine. American Society of Health-System Pharmacists; 2004: 956-8.

c. Bayer Corporation. DTIC-Dome (dacarbazine) prescribing information. West Haven, CT; 2003 May.

d. American Pharmaceutical Partners. Dacarbazine (for injection) prescribing information. Schaumburg, Illinois; 2002 April.