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temozolomide
Used for Brain Tumor
Used for Brain Tumor
Temozolomide (Temodar) treats adults with certain types of brain cancer, like glioblastoma (GBM). It’s a type of chemotherapy called an alkylating agent. Temozolomide (Temodar) usually comes as a capsule you swallow whole once a day. But it’s also available as an injection that’s given through the vein by a healthcare professional at a medical office or infusion clinic. Temozolomide (Temodar) can cause side effects like tiredness, nausea, and hair loss. It also has risks like low blood cell counts and liver problems.
What is Temozolomide (Temodar)?
What is Temozolomide (Temodar) used for?
- Newly-diagnosed glioblastoma (GBM), first with radiation and then by itself as maintenance therapy
- Newly-diagnosed or refractory anaplastic astrocytoma (grade 3 astrocytoma)
How Temozolomide (Temodar) works
Temozolomide (Temodar) is a type of traditional chemotherapy. It’s known as an alkylating agent.
Once temozolomide (Temodar) gets inside a cancer cell, it attaches to the cell’s DNA. This damages the DNA, which usually causes the cancer cell to die. As a result, the cancer cell can’t make copies of itself so the cancer can’t grow.
Drug facts
| Common Brands | Temodar |
|---|---|
| Drug Class | Alkylating agent |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Temozolomide (Temodar)
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
- Tiredness (61%)
- Hair loss (55%)
- Nausea (49%)
- Vomiting (29%)
- Low appetite (27%)
- Headache (23%)
- Constipation (22%)
Less Common Side Effects
- Diarrhea
- Stomach pain
- Rash
- Dry skin
- Cough
- Shortness of breath
- Blurry vision
- Joint pain
- Weakness
- Dizziness
- Trouble sleeping
- Low white blood cell count
- Low platelets
- Injection site reactions, like pain and irritation (with the IV infusion only)
Note: Side effects listed for temozolomide (Temodar) by itself as maintenance therapy for glioblastoma. Side effects might differ when taken with radiation or for people with anaplastic astrocytoma.
Temozolomide (Temodar) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious lung infection: fever, cough, trouble breathing, weakness
- Serious liver problems: belly pain, yellow skin, yellow eyes, swollen belly
- Low platelets: unexplained bruising, nosebleeds
- Serious infection (from having low white blood cell counts): temperature of 100.4ºF or higher, with or without other symptoms, such as chills, cough, muscle aches, very fast heartbeat, confusion
The following Temozolomide (Temodar) 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.
Check with your doctor immediately if any of the following side effects occur:
Less common or rare
Amnesia
black, tarry stools
blood in the urine or stools
convulsions
cough or hoarseness
fever or chills
lower back or side pain
muscle weakness or paralysis on one or both sides of the body
painful or difficult urination
pinpoint red spots on the skin
swelling of the feet or lower legs
unusual bleeding or bruising
Incidence not known
Abdominal or stomach pain or tenderness
blistering, peeling, or loosening of the skin
clay colored stools
decreased appetite
difficulty with swallowing
dizziness
fast heartbeat
headache
joint or muscle pain
nausea or vomiting
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
sores, ulcers, or white spots in the mouth or on the lips
tightness in the chest
troubled breathing
unusual tiredness or weakness
yellow skin or eyes
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:
More common
Less common or rare
blurred or double vision
breast pain (in females)
burning or prickling feeling on the skin
confusion
difficulty with speaking
drowsiness
increased urge to urinate
loss of appetite
loss of muscle coordination
mental depression
runny or stuffy nose
trouble sleeping
unusual weight gain
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.
Get your GoodRx coupon
$113.36
GoodRx discount
$21.91
Pros and cons of Temozolomide (Temodar)
Pros
- Available as a capsule that’s taken by mouth
- Recommended treatment option for certain types of brain cancer
Cons
- Commonly causes nausea and hair loss
- Can have a low white blood cell count, which puts you at risk of infection
Pharmacist tips for Temozolomide (Temodar)
- You might need to take an antibiotic like Bactrim (sulfamethoxazole / trimethoprim) during treatment. This helps prevent you from getting a lung infection. You’re more likely to need it if you're taking temozolomide (Temodar) with radiation or if your white blood cell count is low.
- Temozolomide (Temodar) can cause nausea and vomiting. Your oncologist might give you antiemetics like ondansetron (Zofran) or prochlorperazine to help. They might tell you to take them before each temozolomide (Temodar) dose. You can also take them between doses if you feel nauseous. If this side effect bothers you too much, talk to your care team.
- Temozolomide (Temodar) can put you at risk of getting sick. So, take your temperature often, like once a day. Call your care team right away if it’s 100.4ºF or higher — this means you have a fever. It can sometimes be the only sign that you’re sick, so it’s important to let your oncologist know as soon as possible.
Tips for temozolomide (Temodar) capsules:
- Take temozolomide (Temodar) at the same time each day so it works the best it can for you. It also helps you remember to take your medication by making it a part of your daily routine.
- You can take temozolomide (Temodar) with or without food. But it’s a good idea to take it on an empty stomach or at bedtime. This helps reduce nausea and vomiting.
- Swallow temozolomide (Temodar) capsules whole with water. Don’t crush, open, or chew them because the powder inside can be irritating and harmful.
- If a temozolomide (Temodar) capsule gets damaged, avoid getting the powder on your skin, in your eyes, or in your nose. Wash the area with water right away if this happens though.
- Ask your oncologist if you’re not sure about your temozolomide (Temodar) dose. This includes which capsule strength to take and how many to take. Temozolomide (Temodar) capsules come in different strengths, and you might need to take more than one at a time. Your dose might change during treatment depending on how you tolerate the medication.
- Ask your oncology team about the best way to handle and throw away temozolomide (Temodar) safely. Anticancer medications can be harmful to people who handle or come in contact with them. Keep the medication in a safe place away from children and pets.
Tips for temozolomide (Temodar) IV infusion:
- Plan ahead for some time at the medical center or infusion center for your temozolomide (Temodar) IV infusion. The infusion itself lasts about an hour and a half. But you might need some extra time to do paperwork or get situated. Bring something to do, like a book to read or an electronic device, to help pass the time.
- You might have a reaction where you get your temozolomide (Temodar) IV infusion. You might feel pain, irritation, itchiness, and warmth around the area. There also could be swelling, redness, and bruising. Tell your nurse or oncology team if this happens and it bothers you. They can help manage these injection site reactions.
Risks and warnings for Temozolomide (Temodar)
Temozolomide (Temodar) 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 count
- Risk factors: Older adults | Female
Taking temozolomide (Temodar) can cause your blood cell counts to drop. This can put you at higher risk for infections, anemia, and easy bleeding. Sometimes, it can be very serious.
Your oncologist will check your blood cell counts before each cycle and occasionally during treatment. If your blood cell count gets too low, your oncologist might lower your dose or pause your treatment until it goes back up.
During treatment, watch for signs of infection like fever, chills, or cough. Also look out for signs of anemia, such as feeling tired or having pale skin. And tell your care team if you bleed or bruise more easily than usual.
Serious liver problems
- Risk factors: History of liver problems
Although uncommon, serious liver problems can happen in some people taking temozolomide (Temodar). Sometimes, it can be life-threatening.
Your oncologist will regularly check your liver health with lab tests. So, be sure to go to all the lab appointments your oncologist recommends. Tell your care team if you have belly pain, a swollen belly, yellow skin, or yellow eyes during treatment. These could be signs of liver damage.
Pneumonia
- Risk factors: Also taking corticosteroids | Taking temozolomide (Temodar) together with radiation | Taking temozolomide (Temodar) for a long time
Some people taking temozolomide (Temodar) have gotten a lung infection called Pneumocystis pneumonia (PCP). Your risk is higher if you’re also taking a corticosteroid like dexamethasone. It’s also higher if you’re getting radiation at the same time. Your oncologist might prescribe an antibiotic to help prevent this infection. A common one used is Bactrim (sulfamethoxazole / trimethoprim).
Tell your care team if you have a fever, cough, trouble breathing, chest pain, chills, or feel very tired while taking temozolomide (Temodar). These can be symptoms of PCP.
Risk of new cancers
People taking temozolomide (Temodar) have a higher risk of developing new cancers later. This has included cancers including acute myeloid leukemia (AML). Your oncologist will monitor for this side effect with lab tests, even after you’ve stopped taking temozolomide (Temodar). Talk to your oncologist if you’re worried about this risk.
Harm to an unborn baby
- Risk factors: Pregnancy
Animal studies show that temozolomide (Temodar) might harm an unborn baby or cause pregnancy loss (miscarriage). If you can get pregnant, use reliable birth control while taking this medication and for 6 months after your last dose.
If you’re having sex with someone who can get pregnant, also use birth control like condoms during treatment and for 3 months after stopping. Because temozolomide (Temodar) might affect sperm, don’t donate semen during this time.
Tell your oncologist right away if you or your partner becomes pregnant while you’re taking temozolomide (Temodar).
Temozolomide (Temodar) dosage
The average cost for 15 capsules of 100mg of Temozolomide (Temodar) is $157.72 with a free GoodRx coupon. This is 94.07% off the average retail price of $2,659.63.
Interactions between Temozolomide (Temodar) and other drugs
Temozolomide (Temodar) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Temozolomide (Temodar). Please note that only the generic name of each medication is listed below.
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
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine, Live
- Yellow Fever Vaccine
How much does Temozolomide (Temodar) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Temozolomide (Temodar) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Temozolomide (Temodar) will not be safe for you to take.
- Serious allergic reaction to temozolomide (Temodar)
- Serious allergic reaction to another chemotherapy medication called dacarbazine
What are alternatives to Temozolomide (Temodar)?
There are a number of medications that your doctor can prescribe in place of Temozolomide (Temodar). Compare a few possible alternatives below.
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