Temozolomide
Temozolomide – Uses, Side Effects, Treatment
Introduction
Temozolomide, marketed as Temoside 100 Capsule, is a chemotherapy medication that is taken orally and is mainly employed for the management of brain tumours, i.e., glioblastoma multiforme (GBM) and anaplastic astrocytoma. Temozolomide is a class of alkylating agents that function by causing damage to the DNA of cancer cells, thus checking their growth and preventing their proliferation.
This drug is prescribed in those patients whose brain tumours worsened or occurred again following usual treatment. Taking Temozolomide precisely as ordered by a physician is imperative to ensure maximum benefit through therapy with reduced side effects.
Salt Composition and Mechanism of Action
Temozolomide belongs to the class of dacarbazine derivatives and acts as an alkylating agent. When administered orally, Temozolomide spontaneously hydrolyses at physiological pH to yield its active metabolite, 5-(3-methyltriazen-1-yl)imidazole-4-carboxamide (MTIC). MTIC is the one that causes DNA damage in cancer cells by alkylation at the O6 and N7 positions of guanine residues. This eventually results in cell cycle arrest and apoptosis (programmed cell death), which inhibits tumour growth.
Uses of Temozolomide
1. Treatment of Brain Tumors
- Glioblastoma Multiforme (GBM): GBM is a very aggressive and prevalent form of malignant brain tumour. Temozolomide is also utilized as an adjunct to conventional therapy in association with radiation in an attempt to enhance survival among GBM patients.
- Anaplastic Astrocytoma: Temozolomide is another kind of malignant brain tumour that can be successfully treated as a first-line treatment or when the tumour returns after receiving other treatments.
2. Off-Label Uses
Temozolomide is sometimes used off-label for other cancers, including:
- Metastatic melanoma
- Neuroendocrine tumors
- Soft tissue sarcomas
Dosage and Administration
- Recommended Dosage: Temozolomide dosage differs based on the body surface area of the patient and the nature of the tumour to be treated. For glioblastoma, usually, the routine dosage is 75 mg/m² per day for 42 days, with the maintenance of 150-200 mg/m² every five days of a 28-day cycle.
- Mode of Administration: To improve absorption and efficacy, it should be taken at the same time every day, on an empty stomach.
- Missed Dose: Unless the next planned dose is almost due, missed doses should be taken as soon as remembered. Avoid taking two doses at once.
Side Effects of Temozolomide
Temozolomide is a useful chemotherapy drug, but it can have several side effects. Most of these are manageable, but if they occur severely, consult a doctor.
Common Side Effects:
- Nausea and vomiting
- Constipation or diarrhoea
- Headache and dizziness
- Weakness and fatigue
- Insomnia
- Loss of hair (alopecia)
Serious Side Effects:
- Bone marrow depression (low white blood cell and platelet count, putting you at higher risk of infection and bleeding)
- Seizure or convulsion
- Allergic reactions (rash, shortness of breath, swelling)
- Severe liver failure
Precautions and Warnings
- Pregnancy and Breastfeeding
- Pregnancy: Temozolomide is contraindicated during pregnancy because it can be harmful to the unborn fetus.
- Breastfeeding: Not recommended, as the drug has the potential to pass into the breast milk and potentially harm the infant.
- Drug Interactions
- Temozolomide should not be combined with some drugs that can increase the risk of adverse effects, including:
- Lenograstim, Molgramostim, Sargramostim, and Pegfilgrastim: These drugs, when used together with Temozolomide, can worsen bone marrow suppression.
- Natalizumab: Enhances the risk of infections when used with Temozolomide.
Conclusion
Temozolomide (Temoside 100 Capsule) is an important drug used in the treatment of malignant brain tumours. By adhering to prescribed norms, having regular medical check-ups, and following precautions, patients can enhance their treatment results. Always consult a physician for specific medical advice before initiating or altering your chemotherapy regimen.
FAQ
Temozolomide stops the growth of tumors by adding methyl groups to the DNA of cancer cells, which kills the cells.
The response to treatment is different for each person. Some patients will begin to notice improvement within a few weeks, but for others, it can take several months.
Alcohol should be avoided since it might make side effects such as liver damage, nausea, and dizziness worse.
- Use proper contraception during therapy and for at least six months following the end of the treatment.
- Regular blood tests are necessary to monitor blood cell counts.
- Minimize activities that will potentially increase bleeding or infection.
Yes, it is usually administered in combination with radiation therapy or other chemotherapy agents, depending on the treatment regimen ordered by the oncologist.
If you get severe symptoms such as persistent vomiting, high fever, abnormal bruising, or infection signs, report to the doctor immediately.
Temozolomide does not treat brain tumours but drastically retards their growth and enhances survival when taken alongside other drugs.
Keep the drug at room temperature, away from direct sunlight and humidity. Store it out of children's and pet's reach.
If a dose is forgotten, take it as soon as possible unless it is almost time for the next dose. Do not double the dose.
Yes, it is usually administered in combination with radiation therapy or other chemotherapy agents, depending on the treatment regimen ordered by the oncologist.