Adult: In combination w/ doxorubicin: 250 mg/m2 once daily by infusion over 15-30 min for 5 days, repeat at 3-wk intervals.
Intravenous Metastatic melanoma
Adult: 2-4.5 mg/kg daily for 10 days, repeat at 4-wk intervals or 200-250 mg/m2 daily via inj over 1 min for 5 days, repeat at 3-wk intervals or 850 mg/m2 via infusion over 15-30 min once every 3 wk.
Intravenous Hodgkin's disease
Adult: In combination w/ doxorubicin, bleomycin and vinblastine (ABVD regimen): 150 mg/m2 daily for 5 days, repeat at 4-wk intervals or 375 mg/m2 via infusion over 15-30 min once every 15 days.
Reconstitute 100 mg and 200 mg w/ 9.9 mL and 19.7 mL sterile water for inj, respectively, to a concentration of 10 mg/mL. Further dilute for infusion by adding up to 250 mL of dextrose 5% or NaCl 0.9%.
Incompatible w/ allopurinol, cefepime, piperacillin/tazobactam, heparin, hydrocortisone Na succinate, L-cysteine, Na hydrogen carbonate.
Hypersensitivity. Severe myelosuppression (e.g. leucopenia and/or thrombocytopenia). Severe hepatic or renal impairment. Pregnancy and lactation.
Hepatic and renal impairment.
Anorexia, vomiting, nausea, rash, alopecia, facial flushing and paraesthesia, orthostatic hypotension, ECG abnormalities, flu-like syndrome, myalgia, malaise, blurred vision, seizure, headache, confusion, lethargy, pain at inj site, tissue damage, cellulitis. Rarely, diarrhoea, photosensitivity, stomatitis. Potentially Fatal: Anaphylaxis, bone marrow suppression (particularly leucopenia and thrombocytopenia), hepatotoxicity accompanied by hepatic vein thrombosis and hepatocellular necrosis.
Monitor CBC w/ differential, leukocyte, erythrocyte and platelet count, LFT; infusion site for extravasation. Assess signs of infection and hepatotoxicity.
Symptoms: Severe bone marrow suppression, nausea, vomiting, diarrhoea. Management: Supportive treatment.
Increased metabolism when used w/ enzyme inducers (e.g. barbiturates, rifampicin, phenytoin). May potentiate the effect of mercaptopurine, azathioprine, allopurinol. May impair immune response to vaccines. May enhance the effects of methoxsalen due to photosensitisation.
Increased hepatotoxic effect w/ alcohol.
Description: Dacarbazine is a non-cell cycle specific antineoplastic agent. The exact mechanism of action by which it exerts cytotoxic effects is still unclear. However, three possible mechanisms have been postulated, including inhibition of DNA synthesis by acting as a purine analog, action as an alkylating agent, and interaction w/ sulfydryl group in the inhibition of bacterial cell growth. Pharmacokinetics: Distribution: Rapidly distributed; localised in some body tissues, probably the liver. Crosses the blood-brain barrier. Volume of distribution: Exceeds total body water content. Plasma protein binding: 5%. Metabolism: Metabolised extensively in the liver by CYP1A2 and CYP2E1 enzymes (and possibly in the tissues by CYP1A1) to 5-(3-methyl-triazeno-1-yl)-imidazole-4-carboxamide (MTIC) which is further metabolised to the major metabolite, 5-amino-imidazole-4-carboxamide (AIC). Excretion: Via urine, approx 40% as unchanged drug. Elimination half-life: Biphasic: 19 min (initial); 5 hr (terminal).
Store between 2-8°C. Protect from light. Protect from light. This is a cytotoxic drug, avoid contact w/ skin or mucous membranes by wearing gloves and protective equipment. Wash hands before and after handling. Pregnant staff should not handle this product. Any unused portions should be disposed of in accordance w/ standard procedures.
L01AX04 - dacarbazine ; Belongs to the class of other alkylating agents. Used in the treatment of cancer.
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