Patient Medication Information: uses, side effects, how to take - Temozolomide Capsules
ABOUT THIS MEDICATION
What the medication is used for:
- Temozolomide Capsules in combination with radiotherapy is used in the treatment of adult patients with newly diagnosed glioblastoma multiforme (GBM) (a form of brain tumor) and then as maintenance therapy.
- Temozolomide Capsules alone is used in the treatment of adult patients with recurrent or progressive GBM or anaplastic astrocytoma (AA) after standard therapy.
What it does:
Temozolomide is an antitumor agent. Temozolomide acts on cancer cells. Normal cells may also be affected which may lead to side effects (See Warnings and Precautions section).
When it should not be used:
This medicine should not be used:
- If you are allergic to Temozolomide Capsules (temozolomide) or to any of its ingredients.
- If you have had an allergic reaction to dacarbazine (DTIC), another drug used to treat cancer.
- If you have low blood cell counts (severe myelosuppression).
What the medicinal ingredient is:
Temozolomide Capsules medicinal ingredient is temozolomide.
What the nonmedicinal ingredients are:
The Temozolomide Capsule’s non-medicinal ingredients: colloidal silicon anhydrous, lactose anhydrous, sodium starch glycolate, stearic acid and tartaric acid; capsule shells contain gelatin and, titanium dioxide and branded with black printing ink consisting of shellac, propylene glycol, strong ammonia solution, black iron oxide and potassium hydroxide. 5 mg capsule shells also contain yellow iron oxide and FD & C blue no. 2, 20 mg capsule shells also contain yellow and red iron oxides.
What dosage forms it comes in:
Each Temozolomide Capsule contains 5 mg (white body with green cap), or 20 mg (white body with orange cap).
Temozolomide Capsules are supplied in a unit dose sachet containing 1 capsule, in cartons of 5 or 20 sachets.
WARNINGS AND PRECAUTIONS
Serious Warnings and Precautions
Temozolomide Capsules should be prescribed by doctor experienced with the use of cancer drugs. Temozolomide Capsules may cause a severe decrease in the production of blood cells which may be life threatening. Temozolomide Capsules may cause liver problems which may be life threatening. |
Nausea and vomiting are very common with the use of Temozolomide Capsules.
Temozolomide Capsules combination with radiotherapy may cause severe pneumonia (Pneumocystis carinii).
BEFORE you use Temozolomide Capsules talk to your doctor or pharmacist if you:
- have liver problems,
- have kidney problems,
- have a history of hepatitis B or current hepatitis B infection,
are pregnant or planning to become pregnant,
- are breast feeding, or
- plan to father a child (or seek advice on cryoconservation, a laboratory technique which involves freezing of sperm).
In some cases, patients who have had hepatitis B might have a repeat attack of hepatitis. Tell the doctor if you think you have had hepatitis B in the past.
Infection with hepatitis B virus causes inflammation of the liver which may show as a mild fever, feeling of sickness, fatigue, loss of appetite, joint and./or abdominal pain and yellowing of whites of the eyes, skin and tongue. If you experience any of these symptoms immediately contact your doctor.
Temozolomide Capsules may cause harm to your unborn child, both male and female patients should use effective method of birth control while taking Temozolomide Capsules and for 6 months after the last dose of Temozolomide Capsules.
Male patients should also be advised that Temozolomide Capsules may cause irreversible infertility.
Do not drive or use machines until you know how you react to Temozolomide Capsules.
INTERACTIONS WITH THIS MEDICATION
To avoid the possibility of one drug affecting another drug, be sure to advise your doctor or pharmacist of any other medications you are taking. Valproic Acid is an example of such drug interaction.
PROPER USE OF THIS MEDICATION
Your doctor will determine the dose of Temozolomide Capsules based on your height and weight (m2). Take Temozolomide Capsules as instructed by your doctor.
Usual dose:
Adult Dose:
Newly diagnosed Glioblastoma Multiforme (GBM): Concomitant with Radiotherapy: 75 mg/m2 daily for 42 days (up to 49 days).
Maintenance phases: 150 mg/m2 daily for 5 days for the first cycle, then 200 mg/m2 daily for cycle 2 to 6 if tolerated (a cycle equals 28 days).
GBM or anaplastic astrocytoma (AA) Recurrence or Progression after Standard Therapy:
Previously untreated with chemotherapy: 200 mg/m2 daily for 5 days every 4 weeks per 28 day cycle.
Previously treated with chemotherapy: 150 mg/m2 daily for 5 days for the first cycle to be increased in the second cycle to 200 mg/m2 once daily for 5 days, if no hematologic toxicity.
How Temozolomide Capsules are taken:
Temozolomide Capsules are taken by mouth, on an empty stomach, at least one hour before a meal.
Swallow the capsule whole with a glass of water. Do not open or chew the capsule.
Avoid contact with your skin, eyes, and nose.
You may be given other medicines to prevent nausea and vomiting.
Overdose
In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.
Missed Dose:
Temozolomide Capsules: If you miss a dose, or vomit after taking a dose, contact your doctor for instructions.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
Like all medicines, Temozolomide Capsules can have unintended or undesirable, so called side effects.
Contact your doctor immediately if you have a severe allergic reaction (which may include hives, wheezing or other breathing difficulty).
Common side effects of Temozolomide Capsules during concomitant and maintenance treatment, in descending order of frequency, include: hair loss, fatigue, nausea (feeling sick), vomiting, loss of appetite or weight, constipation, headache, rash, diarrhoea, blurred vision, anemia (reduction in blood cells), fever, muscle weakness, and sleepiness.
In case of vomiting, ask your doctor about controlling the vomiting, and the best time to take Temozolomide Capsules until the vomiting is under control.
Temozolomide Capsules treatment can cause a reduction in certain kinds of blood cells. This may cause you to have increased bruising or bleeding, anemia, fever, and/or a reduced resistance to infections. The reduction of blood cells is usually transient, but in some cases may be prolonged, and may lead to a very severe form of anemia (aplastic anemia) which may be life threatening. Your doctor will monitor your blood regularly for any changes, and will decide if any specific treatment is needed. In some cases, your Temozolomide Capsules dose will be reduced or discontinued.
If you are receiving Temozolomide Capsules for the 42 day regimen, in combination with radiation treatment, your doctor will also prescribe medicine to help prevent a serious form of pneumonia called Pneumocystis carinii pneumonia (PCP).
Less common adverse events, in descending order of frequency, include: convulsions, inflammation of the mouth, cough, radiation injury, dizziness, change in taste, abnormal blood values, shortness of breath, confusion/memory impairment, itching, allergic reaction, insomnia, pain, joint pain, skin dryness, skin redness, abdominal pain, bleeding, chills, hearing impairment, speech disorder, tremor, infection, blood sugar elevation, anxiety, depression, emotional lability, and tingling sensation.
Cases of rash with skin swelling, including on the palms of the hands and soles of the feet, have been observed. Tell your doctor if this occurs.
Cases of lung side effects have been observed with Temozolomide Capsules. Patients usually present with shortness of breath and cough. Tell your doctor if you notice any of these symptoms.
Cases of painful reddening of the skin and/or blister on the body or the mouth, have been observed. Tell your doctor if you notice any of these symptoms.
ADVISE YOUR DOCTOR OR PHARMACIST OF ANY UNDESIRABLE OR TROUBLESOME EFFECT NOT LISTED.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||||
|---|---|---|---|---|
| Symptom/ effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist | ||
| Only if severe | In all cases | |||
| Very Common | Blurred vision; Loss of appetite; Rash; Vomiting; | √ √ √ √ | ||
| Common | Confusion; Convulsion; Diarrhea; Fever, other signs of infection (such as fever, chills, cough); Increased bruising or bleeding; Loss of weight; Memory impairment; Pneumocystis carinii pneumonia (symptoms such as cough that does not go away, trouble breathing, and fever) | √ √ √ √ √ √ √ √ | ||
| Uncommon | Severe allergic reactions including: hives, wheezing or other breathing difficulty; | √ | ||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM |
|---|
| Symptom/ effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist |
|---|
| Only if severe | In all cases |
|---|---|
| Unknown | |
Rash with skin swelling, including on the palms of the hands and soles of the feet (erythema multiforme); Fatigue, pale skin, shortness of breath, rapid heart beat, fever, and bleeding (aplastic anemia); Painful reddening of the skin and/or blister on the body or the mouth [toxic epidermal necrolysis (TEN), Stevens- Johnson syndrome (SJS)]; Shortness of breath and cough (interstitial pneumonitis) ; Jaundice and hepatitis. Liver injury, including liver failure, which may be life threatening. | |
√ √ √ √ | |
| √ | |
This is not a complete list of side effects. For any unexpected effects while taking Temozolomide Capsules, contact your doctor or pharmacist.
HOW TO STORE IT
Temozolomide Capsules:
Do not use this product after the expiration date on the package.
Store at 15°C to 30°C. Protect from moisture.
Store out of the reach and sight of children.
Tell your pharmacist if you notice any change in the appearance of the capsules.
Reporting Side Effects
You can help improve the safe use of health products for Canadians by reporting serious and unexpected side effects to Health Canada. Your report may help to identify new side effects and change the product safety information. 3 ways to report:
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
MORE INFORMATION
If you want more information about Temozolomide Capsules:
- Talk to your healthcare professional
Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada Website; http://www.hc-sc.gc.ca/index-eng.php or by calling 1-855-819-0505
MDA Inc.
206-2401 Bristol Circle
Oakville, Ontario, L6H 5S9
Canada
Last prepared: June 8, 2016