Dacarzin

Indications

Dacarbazine is a cancer medicine used to treat malignant melanoma that has spread, Hodgkin lymphoma (as part of combination chemotherapy such as the ABVD regimen) and some soft tissue sarcomas.

How It Works

Dacarbazine is an alkylating agent. After it is activated in the liver, it attaches chemical groups to the DNA of cancer cells. This damages the DNA so the cells cannot divide and grow, and they die. Healthy fast-dividing cells, such as those in the bone marrow, can also be affected.

Dosage and Administration

Dacarbazine is given as an injection or infusion into a vein by a doctor or nurse in a hospital or cancer centre. The dose is calculated by the cancer specialist from body surface area, the type of cancer and the treatment plan, and is repeated in cycles. It is always given as prescribed. Care is taken to avoid leakage outside the vein, and the infusion bag is protected from light. Blood tests are done before each cycle.

Interactions

• Other medicines that suppress the bone marrow add to the risk of low blood counts.
• Phenytoin and Phenobarbital may change how Dacarbazine is activated in the liver.
• Live vaccines should be avoided during and for some time after treatment.
• Medicines that can harm the liver should be used with care.

Contraindications

• Allergy to Dacarbazine.
• Pregnancy and breastfeeding.
• Severe bone marrow suppression (very low white cells or platelets).
• Severe liver or kidney disease.

Side Effects

Very common side effects include severe nausea and vomiting (anti-sickness medicines are given beforehand), loss of appetite, and low blood counts leading to infections, tiredness and bleeding. Many people have flu-like symptoms (fever, muscle aches, tiredness) for some days after treatment. Other effects include hair thinning, facial flushing or tingling, sensitivity to sunlight, and pain at the injection site. Rarely, a serious liver problem caused by blocked liver veins, or a severe allergic reaction, can occur.

Get urgent medical help if you have a fever of 38°C or higher, chills, unusual bleeding or bruising, sudden pain and swelling in the upper right abdomen, yellowing of the skin or eyes, breathing difficulty or swelling of the face or throat.

Pregnancy and Lactation

Dacarbazine can harm an unborn baby. Women and men should use reliable contraception during treatment and for at least 6 months afterwards, or as advised by the doctor. Do not breastfeed during treatment. It may affect fertility; discuss this with your doctor before starting.

Precautions and Warnings

• Regular blood counts and liver function tests are needed.
• Report signs of infection or bleeding promptly.
• Avoid strong sunlight and use sun protection during treatment and for a few days after each dose.
• Tell the nurse straight away if you feel pain or burning at the drip site.

Overdose

An overdose is unlikely because it is given by health professionals. Too much can cause severe bone marrow suppression. There is no specific antidote; treatment is supportive with blood count monitoring in hospital.

Therapeutic Class

Antineoplastic (anticancer) agent, alkylating agent (triazene).

Storage

Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C, protected from light. Prepared solutions are handled by trained staff.