cedazuridine + decitabine at a glance
Medicine class
Antineoplastic antimetabolite and hypomethylating agent combined with a cytidine deaminase inhibitor.
Licensed use
Newly diagnosed AML in adults ineligible for standard induction chemotherapy.
Administration
Swallow whole with water. Do not eat for two hours before or after taking the tablet.
Key monitoring
Regular blood counts and liver and kidney function tests are required.
What is cedazuridine + decitabine used for?
Licensed as treatment used alone for:
Adults with newly diagnosed acute myeloid leukaemia who are not eligible for standard induction chemotherapy.
How does cedazuridine + decitabine work?
Decitabine enters dividing cells and inhibits DNA methyltransferase after becoming incorporated into DNA. This alters gene methylation and can promote maturation or death of leukaemia cells. Cedazuridine reduces decitabine breakdown in the gut and liver, enabling effective oral exposure.
cedazuridine + decitabine preparations and strengths
Tablet
Route: Oral
Strengths: 35 mg + 100 mg
How to take cedazuridine + decitabine
Follow the schedule supplied by the specialist cancer team.
Swallow tablets whole with water.
Do not eat for two hours before or after taking a tablet.
Do not chew, crush, break or divide tablets because this may release cytotoxic contents.
Follow the cancer team's instructions for any prescribed anti-sickness medicine.
If vomiting occurs after a tablet, do not take a replacement tablet that day.
cedazuridine + decitabine side effects
Common or expected effects
- Reduced white blood cells, platelets or red blood cells
- Infections, including pneumonia and urinary tract infection
- Fever
- Nausea, vomiting or diarrhoea
- Sore or ulcerated mouth
- Raised blood glucose
- Changes in liver blood tests
Get urgent medical advice
- Severe infection or sepsis
- Breathlessness, chest pain or worsening cough
- Unusual or persistent bleeding, or neurological symptoms suggesting bleeding in the brain
- Severe bone-marrow suppression
- Differentiation syndrome
- Inflammation of the lung or bowel
- Heart-muscle disease or heart-failure symptoms
cedazuridine + decitabine in pregnancy
Use during pregnancy is not recommended because the combination may harm the fetus. Pregnancy testing is advised before treatment for anyone who could become pregnant. Effective contraception is required during treatment and afterwards—six months for women who could become pregnant and three months for men who could father a child. Discuss pregnancy or pregnancy plans promptly with the specialist team.
cedazuridine + decitabine while breastfeeding
Breastfeeding is contraindicated because transfer into breast milk is unknown and harm to the infant cannot be excluded.
cedazuridine + decitabine interactions
The cancer team should review all prescribed, non-prescribed and complementary products before treatment.
Cytarabine, gemcitabine or azacitidine
Cedazuridine may increase exposure to these medicines and increase toxicity, so combined use should be avoided.
Other cytidine deaminase inhibitors
These may reduce decitabine breakdown and increase its exposure, so combined use should be avoided.
CYP enzyme inhibitors or inducers
A clinically significant pharmacokinetic interaction is not expected because neither active ingredient is a CYP substrate or inhibitor.
Common questions about cedazuridine + decitabine
Answers are fully visible for fast scanning and source review.
What is cedazuridine + decitabine used for?
It is licensed as treatment used alone for adults with newly diagnosed AML who are not eligible for standard induction chemotherapy.
Why does it contain two active ingredients?
Decitabine acts against leukaemia cells, while cedazuridine reduces its breakdown in the gut and liver so it can be taken orally.
Can it be taken with food?
No. Food can reduce decitabine exposure, so do not eat for two hours before or after taking the tablet.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.