Chemotherapy Patient Resource Area

Temozolomide/Temodar™

Drug
Temozolomide (generic name) is manufactured as Temodar™ (trade name) (Schering Corp., Kenilworth, NJ).

Action
Temozolomide interferes with the growth of cancerous cells. It belongs to a class of drugs known as imidazotetrazine derivatives and is used to treat a type of brain tumor called an astrocytoma.

What does the drug look like?
Temozolomide is supplied in capsules containing various strengths of the drug. The 5-mg capsules have a green imprint, the 20-mg capsules have a brown imprint, the 100-mg capsules have a blue imprint, and the 250-mg capsules have a black imprint.

How long will I take the drug?
The length of treatment depends on how well your body responds to treatment.

How do I take the drug?
Temozolomide is taken by mouth once a day at bedtime, with a full glass of water, on an empty stomach. It usually is given once daily for five days and repeated every 28 days. The dose of temozolomide is based on your body size and is determined by your doctor. Your dose of temozolomide may contain two or more different strengths of temozolomide capsules, and your doctor and pharmacist will tell you how many capsules to take each day. Take your daily dose of temozolomide all at once. Swallow each capsule whole; do not chew or open them. If a capsule accidentally opens or breaks, be careful not to get the contents in your eyes, nose, or mouth. Wash your hands thoroughly if a capsule opens or breaks. Your dose may be adjusted during therapy, and the number of capsules you need to take may change, so follow all directions and medicine labels carefully. If you miss a dose of temozolomide, take it as soon as possible, on an empty stomach. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you accidentally take too many capsules or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature. Do not store it in the bathroom, near the kitchen sink, or in other damp places, because moisture may cause this medication to break down. Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Temozolomide temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination. You will need to have a complete blood count (CBC) drawn on specific days.
• Temozolomide also lowers the number of platelets in your blood, which are necessary for proper blood clotting. DO NOT take aspirin or aspirin-containing medications. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing. Your healthcare providers may give you suggestions on how to care for your mouth, and these directions should be followed carefully.
• About 75% of patients taking temozolomide experience nausea and vomiting. This usually occurs on the first day of each treatment cycle and can be controlled by antinausea medication.
• Temozolomide causes mouth sores in about 20% of people taking this drug. If mouth sores occur, avoid spicy foods and do not use mouthwash, because it may contain alcohol and worsen mouth pain. Your healthcare providers may give you suggestions on how to care for your mouth or manage mouth sores, and these directions should be followed carefully.
• Less common side effects associated with temozolomide include fatigue, headache, constipation, diarrhea, and loss of appetite.
• Temozolomide interferes with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you must use a reliable method of birth control and not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or would like to become pregnant need to discuss this with their doctors before taking this drug.

Drug and food interactions
Let your doctor know what medications you are taking. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stools
• Unusual bruising
• Pinpoint red spots on your skin
• Moderate to severe nausea and vomiting