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Dacarbazine information from DrugsUpdate  

See Available Brands of Dacarbazine in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Dacarbazine (brand names DTIC, DTIC-Dome; also known as DIC or Imidazole Carboxamide) is an antineoplastic chemotherapy drug used in the treatment of various cancers, among them malignant melanoma, Hodgkin lymphoma, sarcoma, and islet cell carcinoma of the pancreas. Antineoplastic drugs are drugs which interfere with cell growth and impede the formation of new tissue - in this case, tumor tissue. These drugs are also known as cytotoxic drugs. Dacarbazine belongs to the family of chemicals known as alkylating agents.

Pharmacodynamics

Pharmacokinetics

The exact mechanism of action is still unclear but it appears to form methylcarbonium ions that attack nucleophilic groups by attaching to the 7-position of guanine on DNA. It also cross-links DNA strands leading to inhibition of DNA, RNA and protein synthesis.


Absorption Poorly absorbed from the GI tract (oral).


Distribution Crosses the blood-brain barrier; localised in the liver. Protein-binding: 5%.


Metabolism Extensively hepatic.


Excretion Urine (as unchanged drug). Elimination half-life: 20 min (initial), 5 hr (terminal).

Dacarbazine Indications / Dacarbazine Uses

Information Not Available

Dacarbazine Adverse Reactions / Dacarbazine Side Effects

Leucopenia, thrombocytopenia, anorexia, nausea, diarrhoea, vomiting; flu-like syndrome, myalgia, malaise, facial flushing, paraesthesia, skin reactions, rashes; alopoecia, photosensitivity reactions. Potentially Fatal: Myelosuppression; hepatotoxicity, anaphylaxis.

Precautions

Warnings Administer under supervision of a qualified physician experienced in use of cancer chemotherapeutic agents; hemopoietic depression is most common toxicity; hepatic necrosis has been reported; carcinogenic and teratogenic effects demonstrated in animals; weigh possibility of achieving therapeutic benefit against risk of toxicity when treating patient. Monitor Ensure that CBC with differential and platelet count is evaluated before starting therapy and then frequently during therapy. Implement infection control measures if WBC drops; implement bleeding precautions if platelet count drops. Assess injection site frequently for signs or symptoms of extravasation (eg, burning, pain, induration). Monitor patient for signs and symptoms of bacterial, viral, or fungal infection. Overdosage Severe bone marrow suppression and eventually, bone marrow aplasia which may be delayed by up to two wk. It can take 4 wk to reach nadir of leucocytes and thrombocytes. Treatment is supportive with long term careful haematological monitoring. There is no known antidote for dacarbazine overdose.

Special Precautions

Hepatic or renal impairment. Pregnancy, lactation.

Other Drug Interactions

Impairs immune response to vaccines; possible infection after admin of live vaccines. Effect increased by CYP1A2 inhibitors e.g. amiodarone, ciprofloxacin, fluvoxamine, ketoconazole, lomefloxacin, ofloxacin and rofecoxib. Effect decreased by CYP1A2 inducers e.g. aminoglutethimide, carbamazepine, phenobarbital and rifampicin.

Other Interactions

Information Not Available

Dosage

Intravenous Metastatic malignant melanoma Adult: 2-4.5 mg/kg daily for 10 days, repeat at 4-wk intervals or 200-250 mg/m2 BSA daily for 5 days, repeat at 3-wk intervals or 850 mg/m2 BSA by infusion, repeat at 3-wk intervals. Intravenous Hodgkin's disease Adult: 150 mg/m2 BSA daily for 5 days, repeat every 4 wk or 375 mg/m2 BSA every 15 days in combination with other agents. Intravenous Soft tissue sarcoma Adult: 250 mg/m2 BSA daily for 5 days repeated every 3 wk. Usually given with doxorubicin. Incompatibility Incompatible with hydrocortisone sodium succinate, L-cysteine, sodium hydrogen carbonate and concentrated heparin (25 mg/ml).

Food(before/after)

Information Not Available

List of Contraindications

Dacarbazine and Pregnancy

Caution when used during pregnancy. Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Dacarbazine and Lactation

Caution when used during lactation

Dacarbazine and Children

Information Not Available

Dacarbazine and Geriatic

Information Not Available

Dacarbazine and Other Contraindications

Bone marrow suppression; hypersensitivity

Storage

Intravenous Store at 2-8 ℃

Lab interference

Intravenous Store at 2-8 ℃

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