temozolomide at a glance
Medicine class
Oral alkylating chemotherapy
Main role
Treating newly diagnosed glioblastoma and recurrent or progressive malignant glioma
Administration
Swallow capsules whole with water on an empty stomach
Key monitoring
Regular blood counts and liver-function tests
What is temozolomide used for?
Licensed uses for the selected capsule product include:
Newly diagnosed glioblastoma in adults, with radiotherapy and subsequently alone.
Malignant glioma, including glioblastoma or anaplastic astrocytoma, that has recurred or progressed after standard treatment, in adults and children aged 3 years or older.
How does temozolomide work?
Temozolomide is converted into an active compound that adds methyl groups to DNA. The resulting abnormal DNA repair can stop susceptible tumour cells dividing and cause cell death. Tumour DNA-repair pathways such as MGMT can reduce sensitivity.
temozolomide preparations and strengths
Capsule
Route: Oral
Strengths: 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg
How to take temozolomide
Follow the oncology team's written instructions carefully because the capsule combination may change during treatment.
Take the capsules without food, preferably at a consistent time on each prescribed treatment day.
Swallow capsules whole with a glass of water; do not open, crush or chew them.
If you vomit after taking temozolomide, do not take a replacement that day.
Use prescribed anti-sickness medicines as directed.
If a capsule is damaged, avoid the powder and wash exposed skin or mucosa thoroughly with soap and water.
temozolomide side effects
Common or expected effects
- Nausea or vomiting
- Constipation or diarrhoea
- Reduced appetite
- Headache
- Tiredness or sleepiness
- Rash
- Reduced white cells, platelets or red cells
Get urgent medical advice
- Fever, chills or other signs of infection
- Unusual bruising, pinpoint spots or uncontrolled bleeding
- Breathlessness or symptoms of pneumonia
- Severe allergic reaction, including wheezing or facial or throat swelling
- Seizures or marked neurological deterioration
- Yellow skin or eyes, dark urine or other signs of liver injury
- Persistent severe reduction in blood cells, including rare aplastic anaemia
temozolomide in pregnancy
Temozolomide can damage genetic material and should not normally be used during pregnancy. Anyone who is pregnant, could become pregnant or is planning pregnancy should speak to the specialist team before treatment. Effective contraception is required during treatment and for at least 6 months afterwards for patients who could become pregnant. Treated men should avoid fathering a child during treatment and for at least 3 months afterwards.
temozolomide while breastfeeding
Breastfeeding should be stopped during treatment because it is unknown whether temozolomide passes into human milk and harm to the infant cannot be excluded.
temozolomide interactions
The oncology team should review all prescribed, over-the-counter and complementary products.
Other medicines or treatments that suppress bone marrow
Combining them with temozolomide may increase low blood counts, infection and bleeding risk.
Valproic acid
It slightly reduces temozolomide clearance and may increase exposure, so toxicity monitoring remains important.
Common questions about temozolomide
Answers are fully visible for fast scanning and source review.
Is temozolomide chemotherapy?
Yes. It is an oral alkylating chemotherapy that damages DNA in susceptible tumour cells.
Which brain tumours is it licensed to treat?
Newly diagnosed glioblastoma in adults and malignant glioma that recurs or progresses after standard treatment in adults and children aged 3 years or older.
Should it be taken with food?
No. Take the capsules on an empty stomach because food reduces and delays peak temozolomide exposure.
What should I do if I vomit after taking it?
Do not take a replacement that day. Contact the oncology team if vomiting continues or you cannot keep medicines down.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.