What is this medication for?
Temozolomide is used to treat certain brain cancer conditions such as glioblastoma multiforme and anaplastic astrocytoma. It may be used in combination with radiotherapy which uses high-energy radiation beams to destroy cancer cells.
Temozolomide works by damaging the DNA inside cells, and this stops cancer cells from multiplying and growing.
How should I take or use this medication?
- Take Temozolomide once a day on an empty stomach, 1 hour before food. Take at the same time every day.
- Temozolomide may be taken every day for 6 to 7 weeks with radiotherapy, or every day for 5 days of a 28-day treatment cycle without radiotherapy.
- Swallow the capsule whole with a full glass of water.
- Do not open, chew or crush the capsule.
- Inform your doctor or pharmacist if you have difficulty swallowing.
- If you are not able to swallow the capsule whole, Temozolomide may be opened and dissolved in acidic juice (such as orange juice or apple juice) or applesauce. Wash the glass and spoon after each use and keep them separate from other kitchen utensils.
- Special handling of the medication is needed.
- Try not to touch the medication with your bare hands. Use the medication cup provided. Wash your hands after handling the medication.
- Temozolomide capsules come in different strengths. Your doctor may prescribe more than one strength for you. It is important to follow the instructions on the number of capsules of each strength to be taken.
What should I do if I forget to take or use this medication?
- If you forget to take a dose, skip the missed dose and take it at the next scheduled time. Do not take two doses to make up for the missed dose.
- If you vomit out a dose of Temozolomide, do not take another dose to make up for it. Take your next dose at the usual time.
What precautions should I take when taking or using this medication?
- Inform your healthcare professional if:
- You are allergic to this medication or dacarbazine, or any of the other ingredients of this medication.
- You are taking any other medications, including supplements, traditional medications and herbal remedies.
- You have any other medical conditions.
- You are going to receive any vaccination or surgery, including dental surgery.
- You have any plans to start a family in the future.
- Temozolomide may have an anti-fertility effect, which could be irreversible. You should discuss fertility preservation options with your doctor before starting treatment.
- You should not become pregnant during treatment. You should use an effective birth control method during treatment and for at least 6 months after stopping Temozolomide.
- If you have a partner who could become pregnant, you should use an effective birth control method during treatment and for at least 3 months after stopping Temozolomide.
- You should not breastfeed during treatment and for at least 1 week after stopping Temozolomide.
What are some common side effects of this medication?
The table below will list some of the common side effects as well as the rare but serious side effects.
| Side Effect | Management |
| Nausea or vomiting |
|
| Liver problems |
|
Risk of Pneumocystis carinii/jirovecii (PCP) infection Temozolomide may weaken your immunity and increase the chance of getting a lung infection caused by the fungus Pneumocystis carinii/jirovecii. |
|
Decrease in white blood cell count. This may increase your chances of getting an infection.
|
|
Decrease in platelet count. Low platelet levels can increase your chance of bleeding.
|
|
Decrease in the number of red blood cells (anaemia) As your red blood cells help to carry oxygen to the different parts of your body, this may cause you to feel tired more easily. |
|
Symptoms of drug allergy including one or more of the following:
| If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately. |
It is normal to experience some side effects from Temozolomide. As discussed with your doctor, taking Temozolomide will be beneficial for your condition. Do not stop taking Temozolomide without checking with your doctor.
What food or medication should I avoid when I take or use this medication?
Avoid eating any raw, uncooked or under-cooked food as your immunity is weakened.
How should I store this medication?
Store in a cool and dry place below 30°C, away from direct sunlight. Keep this medication away from children.
How do I throw away this medication safely?
Pack the medication into a bag and bring it back to the pharmacy where you received the medication from.
What else should I know about this medication?
Tips to help manage your condition while you are on Temozolomide
| Exercise | Light exercise is recommended as it helps to improve mobility, balance, and even emotional well-being. Avoid strenuous exercise, and rest when you are feeling tired. |
| Adequate hydration | Maintain adequate hydration with 2 to 3 litres of fluids per day unless you have been informed by your doctor to limit how much fluids you can drink. This will decrease your chances of getting constipation and prevent dehydration. |
| Seek support if you feel overwhelmed | It is normal to feel fearful or worried about your condition. Do not be afraid to share your concerns with your healthcare team or loved ones. There may be resources and support available to help you. |
Disclaimer
Please take note that the above is not a complete list of all possible side-effects. If you have any concerns about your medication or if you have other side-effects that you think are caused by this medication, please consult your doctor or pharmacist. If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.
This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (NHG Health, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.
Contributed By
- Pharmaceutical Society of Singapore