Temozolomide (TEMODAL)

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Indication

Brain cancer

Melanoma

Sarcoma

Dose

Brain cancer, Melanoma, Sarcoma

Oral: Many dosing regimens, please refer to specific chemotherapy protocol
Given as monotherapy or in combination with other chemotherapy agents or radiation

Supplied

Available as 5 mg, 20 mg, 100 mg, 140 mg, and 250 mg capsules. Capsules contain lactose. Capsules should NOT be opened. Store at room temperature and protect from moisture.

Pharmacological Category

Alkylating agent

Administration

Take with or without food

Missed Dose

If a dose is missed, patients should be instructed to take it as soon as they can if it is within 12 hours of the missed dose. If it is over 12 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Adverse Effects

Common: Nausea, Anorexia, Constipation.

Less Common: Neutropenia, Thrombocytopenia, Hepatotoxicity.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Monitoring Parameters

Baseline before treatment: CBC & differential, platelets, ALT, Bilirubin, serum creatinine, random glucose (for patients on dexamethasone).

During treatment: CBC & differential, platelets, serum creatinine, ALT and bilirubin.

Day 22: CBC & differential, platelets.

If clinically indicated: electrolytes, magnesium, calcium, glucose.

Drug Interactions

Current drug interaction databases should be consulted for more information.

Clinical Pearls

Avoid in pregnancy and lactation.
Nausea and vomiting may be reduced by taking temozolomide on an empty stomach.

References

BC Cancer. BC Cancer Drug Manual. Temozolomide. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Temozolomide_monograph.pdf. Updated March 1, 2018. Accessed January 22, 2024.

Lexicomp. Temozolomide Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/7732?cesid=0tlQZhloACw&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DTemozolomide%26t%3Dname%26acs%3Dfalse%26acq%3DTemozolomide. Updated January 27, 2024. Accessed January 31, 2024.

Cancer Care Ontario. Temozolomide Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/43726 . Updated June 2021. Accessed January 22, 2024.

Schering Canada. TEMODAL® Product Monograph. Pointe-Claire, Quebec. Updated August 16, 2022.