Classification: Alkylating Agent
Temozolomide exerts its anti-cancer affect by a process called alkylation. Alkylation damages the DNA of cells, which prevents them from dividing and causes them to die. Temzolomide is similar to the drug dacarbazine (DTIC), and patients who have had allergic reactions to dacarbazine should not take temozolomide.
Temozolomide is given in a capsule form, taken once a day on an empty stomach (1 hour before a meal or 2 hours after). This helps to prevent nausea associated with this medication. You should take this medication around the same time each day. Be sure to swallow the capsules whole, (do not open or chew them) and take with a full glass of water. The dose is dependent on your body size, the regimen your doctor is following, and whether or not it is being used in conjunction with other chemotherapies or radiation therapy.
When taking temozolomide in conjunction with radiation, you will be given a medication to prevent a certain type of pneumonia called PCP.
There are a number of things you can do to manage the side effects of Temozolomide. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4°), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips to preventing infection:
For more suggestions, read the Neutropenia Tip Sheet.
Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. Let your doctor or nurse know if you have any excess bruising or bleeding, including nose bleeds, bleeding gums or blood in your urine or stool. If the count becomes too low, you may receive a transfusion of platelets.
Read the thrombocytopenia tip sheet for more information.
Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.
Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink’s section on fatigue for helpful tips on dealing with this side effect.
There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day and keep active. Your doctor or nurse can also recommend medications to relieve constipation. A stool softener and/or stimulant, such as senna, once or twice a day may prevent constipation. Notify your healthcare team if you do not have a bowel movement for 3 or more days.
Your hair may become thin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun. Read more on alopecia.
Your doctor or nurse can recommend medication and other strategies to relive pain.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment, even if your menstrual cycle stops or you believe your sperm is affected.