Indications
Decitabine is a prescription cancer medicine used for myelodysplastic syndromes (MDS), a group of bone marrow disorders in which the marrow does not make enough healthy blood cells, and for acute myeloid leukaemia (AML) in adults who cannot have intensive chemotherapy. Treatment is decided by a blood cancer specialist (haematologist).
How It Works
Decitabine is a hypomethylating agent. In MDS and AML, chemical tags called methyl groups switch off genes that normally control cell growth and maturation. Decitabine is taken into dividing cells and blocks the enzyme that adds these tags (DNA methyltransferase). This can switch the genes back on, helping blood cells mature normally, and at higher levels it directly kills abnormal cells.
Dosage and Administration
Decitabine is given as an infusion into a vein by a doctor or nurse in a hospital or cancer centre, over several consecutive days in repeated cycles, usually about every 4 weeks. The dose is based on body surface area and the chosen schedule, and is adjusted according to blood counts. At least 4 cycles are often needed before the full benefit is seen. Use only as prescribed.
Interactions
No major drug interactions are known. Tell your doctor about all medicines; live vaccines should be avoided, and medicines that lower blood counts may add to its effect on the bone marrow.
Contraindications
- Allergy to Decitabine or any ingredient
- Breastfeeding
Side Effects
- Low blood counts: low white cells (with risk of infection and fever), low platelets (bleeding, bruising), anaemia (tiredness, breathlessness)
- Fever, infections including pneumonia
- Nausea, diarrhoea, constipation, mouth sores, loss of appetite
- Headache, cough, swelling of the legs
Get urgent medical help if you have a fever of 38°C or higher, chills, shortness of breath, unusual bleeding or bruising, blood in the urine or stools, or signs of a severe allergic reaction.
Pregnancy and Lactation
Decitabine can harm an unborn baby and must not be used in pregnancy. Women should use effective contraception during treatment and for at least 6 months after the last dose, and men with partners who could become pregnant should use effective contraception during treatment and for at least 3 months after the last dose. It may affect fertility. Do not breastfeed during treatment.
Precautions and Warnings
- Blood counts, liver and kidney function are checked before each cycle.
- Tell your doctor at once about any fever or sign of infection.
- Use a soft toothbrush and avoid injuries if platelets are low.
- Tell your doctor about heart, liver or kidney disease.
Overdose
Decitabine is given by health professionals, so overdose is unlikely. Overdose would increase bone marrow suppression; there is no antidote and supportive care is given in hospital.
Therapeutic Class
Antineoplastic antimetabolite (hypomethylating agent, DNA methyltransferase inhibitor).
Storage
Hospital medicine. Store unopened vials as directed on the pack, usually below 25°C. Prepared solutions must be used within the time stated in the leaflet. Handled only by trained staff using safety precautions for cytotoxic medicines.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.