decitabine at a glance
Medicine class
Antineoplastic antimetabolite and DNA-hypomethylating agent
Licensed role
Newly diagnosed acute myeloid leukaemia in adults unsuitable for standard induction chemotherapy
Key monitoring
Regular blood counts, with liver and kidney function assessment during treatment
What is decitabine used for?
The selected product has one licensed indication.
Treatment of adults with newly diagnosed de novo or secondary acute myeloid leukaemia, classified according to WHO criteria, who are not candidates for standard induction chemotherapy.
How does decitabine work?
Decitabine is converted inside cells into an active form that becomes incorporated into DNA. It inhibits DNA methyltransferases, reducing abnormal DNA methylation. This may reactivate tumour-suppressing pathways, promote cell maturation or ageing, and trigger programmed death of leukaemia cells.
decitabine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 50 mg
How to take decitabine
This formulation is prepared and given as an intravenous infusion by trained healthcare professionals. It is not taken by mouth, and a central venous catheter is not essential. Tell the team about all prescribed, non-prescription and herbal products before treatment.
Attend the specialist treatment unit as arranged.
Do not handle or attempt to prepare the product yourself.
If tired or weak after treatment, avoid driving or operating machinery until you feel able to do so safely.
decitabine side effects
Common or expected effects
- Fever
- Anaemia, which may cause tiredness, weakness or pallor
- Low platelets, causing easier bruising or bleeding
- Low white-cell counts, including neutropenia
- Infections, including pneumonia and urinary infection
- Nausea, vomiting or diarrhoea
- Headache or nosebleeds
- Raised blood glucose or abnormal liver-test results
Get urgent medical advice
- Fever or other infection symptoms, particularly with low white-cell counts
- Chest pain, cough or breathlessness from pneumonia, lung inflammation or heart problems
- Significant bleeding or symptoms suggesting bleeding within the head
- Severe allergic reaction with breathing difficulty, swelling, itching or rash
- Differentiation syndrome, with fever, breathing difficulty, swelling, low blood pressure, reduced urine or rapid weight gain
- Severe abdominal pain, bloating or diarrhoea suggesting enterocolitis
decitabine in pregnancy
Decitabine should not be used during pregnancy because its mechanism and animal evidence indicate potential fetal harm. Pregnancy testing is required before treatment for people who could become pregnant. Effective contraception is required during treatment and for 6 months afterwards for women. Men should avoid fathering a child during treatment and for 3 months afterwards. Discuss fertility preservation before treatment where relevant.
decitabine while breastfeeding
Breastfeeding is contraindicated during decitabine treatment. It is unknown whether decitabine or its metabolites enter breast milk, so breastfeeding must stop if treatment is required.
decitabine interactions
Formal clinical interaction studies have not been conducted. The oncology team should review all medicines, supplements and herbal products.
Medicines activated by intracellular phosphorylation
Combined use could theoretically alter activation or effects, so specialist review and caution are required.
Medicines metabolised by cytidine deaminase
Competition for this metabolic pathway could theoretically affect exposure; the specialist team should review the combination.
Hormonal contraceptives
Their use with decitabine has not been studied, so discuss contraception with the treating team.
Common questions about decitabine
Answers are fully visible for fast scanning and source review.
Is decitabine chemotherapy?
Yes. Decitabine is an anticancer antimetabolite, often described as a hypomethylating agent.
Which cancer is decitabine licensed to treat?
The selected product is licensed for certain adults with newly diagnosed acute myeloid leukaemia who are unsuitable for standard induction chemotherapy.
Is decitabine given as tablets or an infusion?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.