dacarbazine
Dacarbazine is a chemotherapy medication called an alkylating agent. It's mainly used to treat Hodgkin’s lymphoma (also called Hodgkin’s disease). This medication is also approved for melanoma, a type of skin cancer. Dacarbazine doses are given at an infusion center or clinic as an injection into the vein (intravenous or IV). Possible side effects include nausea, loss of appetite, and low blood cell counts. Dacarbazine is a generic medication; the brand name DTIC-Dome is no longer available.
What is Dacarbazine?
What is Dacarbazine used for?
- Hodgkin’s lymphoma, given with other anticancer medications
- Metastatic melanoma (cancer that has spread)
How Dacarbazine works
Dacarbazine is a type of traditional chemotherapy medication that works to slow or stop the cancer from spreading. More specifically, it’s an alkylating agent.
Dacarbazine works by attaching to the cancer cell’s DNA and damaging the DNA. This usually kills the cancer cell.
Drug facts
Side effects of Dacarbazine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Vomiting
- Poor appetite
- Low white blood cell count
- Low red blood cell count
- Low platelets
Less Common Side Effects
- Flu-like symptoms
- Fever
- Muscle aches
- Hair loss
- Flushing
- Numbness in the face
- Skin rash
Dacarbazine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infection (from having low white blood cell counts): temperature of 100.4 degrees Fahrenheit or higher, with or without other symptoms like chills, cough, muscle aches, very fast heartbeat, or confusion
- Low red blood cell counts or low platelets: severe tiredness, nosebleeds, unexplained bruising or bleeding, bleeding that's hard to stop
- Liver problems: nausea, vomiting, tiredness, stomach pain or swelling, pale-colored stool, dark-colored urine, yellowing of the whites of the eyes or skin
- Serious allergic reaction: sudden trouble breathing, tightness in the throat or chest, itchy rash, sudden confusion
The following Dacarbazine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Check with your doctor immediately if any of the following side effects occur:
More common
Redness, pain, or swelling at place of injection
Check with your doctor as soon as possible if any of the following side effects occur:
Rare
Sores in mouth and on lips
Some side effects 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:
This medicine may cause a temporary loss of hair in some people. After treatment with dacarbazine has ended, normal hair growth should return.
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
Black, tarry stools
blood in urine or stools
cough or hoarseness, accompanied by fever or chills
fever or chills
lower back or side pain, accompanied by fever or chills
painful or difficult urination, accompanied by fever or chills
pinpoint red spots on skin
unusual bleeding or bruising
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Dacarbazine
Pros
- Is part of a recommended treatment plan for Hodgkin’s lymphoma
Cons
- Often causes low blood cell counts, which can put you at risk for infections and bleeding
- Commonly causes nausea
Pharmacist tips for Dacarbazine
- Tell the nurse right away if you feel any pain, burning, or warmth during your dacarbazine infusion. It's possible for the medication to leak from the vein and reach healthy tissue nearby, which can be painful. Your care team will try to prevent this from happening by giving you a certain type of IV access device, like a port.
- Dacarbazine commonly causes nausea and vomiting. Your oncologist will prescribe antiemetics, like ondansetron (Zofran) or prochlorperazine, for you to take at home (if they haven’t already). Contact your care team if the nausea or vomiting becomes too bothersome.
- Make sure you drink plenty of fluids to stay hydrated if you experience vomiting as a side effect of dacarbazine. This is also helpful if you have diarrhea, which is another possible but pretty rare side effect. Avoid sugary sports drinks though because sugar won't help replace the electrolytes you've lost and can make diarrhea worse. Talk with your care team if you need help managing these side effects.
- Dacarbazine often causes you to have a low white blood cell count. This can make it hard for your body to fight infections well if you get sick. You can help prevent getting infections by washing your hands often, avoiding crowds, and washing raw fruits and vegetables thoroughly before eating them.
- Check your temperature regularly, such as once a day. Call your care team as soon as possible if your temperature is 100.4 degrees Fahrenheit or higher; this means you have a fever. Sometimes, having a fever can be the only sign that you’re sick. It’s important to let your care team know if you get sick so they can help prevent any infections from getting worse.
- Sometimes, dacarbazine can irritate your liver. Be sure to get any blood tests that your oncologist tells you to do during treatment. Your oncologist uses these test results to check your liver health and make sure it's safe for you to keep taking this medication. Call your care team right away if you have stomach pain, yellowish skin, or yellow around the whites of your eyes since these can be signs of liver problems.
Common questions about Dacarbazine
Dacarbazine is most commonly used for Hodgkin’s lymphoma. It’s used as part of a chemotherapy combination regimen called ABVD, which is considered a first-choice treatment option for some people with Hodgkin’s lymphoma. Dacarbazine is also sometimes used off-label to treat a type of cancer called soft tissue sarcoma. This medication is FDA approved for treating metastatic melanoma as well. But the treatment options for melanoma have changed over the last few decades, and dacarbazine is rarely used to treat melanoma now.
The most common side effect of dacarbazine is having a low number of blood cells in your body. Dacarbazine can cause your white blood cell count to drop. Your white blood cells help your body fight infection. So when their levels are low, your body can't fight off an infection as well if you get sick. This medication can also cause you to have fewer red blood cells, leading to anemia and making you feel tired. In addition, dacarbazine can cause you to have fewer platelets in your blood, which can put you at risk for bleeding. Your oncologist will keep track of your blood cell counts very closely while you’re taking dacarbazine. Contact your care team if you have any unexpected bruising or bleeding or if you feel very tired. These can be signs that you have low blood cell counts.
Yes, dacarbazine has a high risk of causing nausea and vomiting. Because of this high risk, it’s important to take medications to prevent nausea along with dacarbazine. Your oncologist will prescribe anti-nausea medications that you can either take by mouth or get through your IV on the same day you get chemotherapy. Your oncologist will also prescribe anti-nausea medications for you to take at home if you need them in between treatments. Contact your care team if you have severe nausea that doesn’t get better with medications so they can help you manage this side effect.
How long you'll need to take dacarbazine depends on many factors. Your oncologist will consider the type and stage of cancer you have, what other anti-cancer medications you're taking, how well treatment is working, and whether you’re having any bothersome or serious side effects. For example, how many treatments of dacarbazine you get as part of the ABVD treatment plan for Hodgkin’s lymphoma depends on the stage of your cancer and how well you’re responding to therapy. You'll need PET scans done regularly so your oncologist can see how well treatment is working Make sure to follow up with your oncologist regularly to discuss your progress with dacarbazine.
Some people who take dacarbazine have experienced hair loss. Many of the medications often given with dacarbazine cause hair loss, too. Typically, your hair will grow back after you stop chemotherapy. Let your care team know if you experience hair loss during treatment with dacarbazine. They can discuss with you about ways to prevent more hair loss. Your care team can also provide resources about wigs, wraps, and scarves to help you cope with this side effect.
Talk with your oncologist if you’re pregnant or thinking about becoming pregnant. Dacarbazine hasn’t been well studied in human pregnancies. But animal studies show that the medication might cause harm to an unborn baby. Your oncologist will discuss with you about the risks of taking dacarbazine during pregnancy.
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Risks and warnings for Dacarbazine
Dacarbazine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood cell counts
Dacarbazine commonly causes low blood cell counts, which can sometimes be dangerous. Low red blood cell counts can lead to problems like anemia and tiredness. And low platelet levels can put you at risk for bleeding. What's more, a low white blood cell count puts you at risk for serious and life-threatening infections because your immune system is weaker. You might be more likely to have complications from having low white blood cell counts if you’re older than 65 or if you’ve had chemotherapy or radiation before.
Your oncology care team will check your blood cell counts before every dacarbazine treatment. They'll pay closer attention to your white blood cell counts. If your counts are too low, your oncologist might make adjustments to your treatment to give your body time to make new blood cells.
Since your immune system can get weak during treatment and you're at risk for infections, it’s important to do your best to avoid getting sick. Wash your hands often and avoid crowds. Check your temperature regularly, and call your care team right away if your temperature is 100.4 degrees Fahrenheit or higher.
Liver problems
Rarely, some people who took dacarbazine developed liver damage, including blood clots in their liver. This mostly happened when dacarbazine was given with other chemotherapy medications.
Your oncology care team will keep track of your liver health on a regular basis to make sure dacarbazine is still safe for you to take. If your liver test results are too high, your oncologist might pause or stop your treatment with dacarbazine while they check for possible problems. Call your care team right away if you experience symptoms of liver problems, such as stomach pain, yellowish skin, or yellow around the whites of your eyes.
Harm to an unborn baby
Based on animal studies, dacarbazine might harm an unborn baby or raise the risk for miscarriage (pregnancy loss) if it's given during pregnancy. Let your oncologist know right away if you become pregnant while you're getting treated with dacarbazine.
Allergic reaction
It’s possible to have a serious allergic reaction called anaphylaxis after you get your dacarbazine injection. Get medical attention as soon as possible if you have sudden trouble breathing, tightness in your throat or chest, an itchy rash, or sudden confusion.
Dacarbazine dosage
Interactions between Dacarbazine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Dengue Tetravalent Vaccine, Live
- Influenza Virus Vaccine, Live
- Pexidartinib
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine, Live
- Yellow Fever Vaccine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aldesleukin
Dacarbazine images
