Newly Diagnosed Glioblastoma Multiforme : Zolomide is indicated for the treatment of adult patients with newly diagnosed glioblastoma multiforme concomitantly with radiotherapy and then as maintenance treatment. Refractory Anaplastic Astrocytoma : Zolomide is indicated for the treatment of adult patients with refractory anaplastic astrocytoma, i.e., patients who have experienced disease progression on a drug regimen containing nitrosourea and procarbazine.
Temozolomide is not directly active but undergoes rapid nonenzymatic conversion at physiologic pH to the reactive compound Methyl Triazen Imidazole Carboxamide (MTIC). The cytotoxicity of MTIC is thought to be primarily due to alkylation of DNA. Alkylation (methylation) occurs mainly at the 0 6 and N 7 positions of guanine.
Newly Diagnosed GBM : 75 mg/m 2 for 42 days concomitant with focal radiotherapy followed by initial maintenance dose of 150 mg/m 2 once daily for Days 1-5 of a 28-day cycle of Temozolomide for 6 cycles. Refractory Anaplastic Astrocytoma : Initial dose 150 mg/m 2 once daily for 5 consecutive days per 28-day treatment cycle.
The most common adverse effects are: alopecia, fatigue, nausea, vomiting, headache, constipation, anorexia, convulsions, rash, hemiparesis, diarrhea, asthenia, fever, dizziness, coordination abnormal, viral infection, amnesia, and insomnia. The most common Grade 3 to 4 hematologic labcratory abnormalities that have developed during treatment with Zolomide are: lymphopenia, thrombocytopenia, neutropenia, and leukopenia. Allergic reactions have also been reported.
Always consult a registered doctor before taking any medicine. This information is for general knowledge only.
Temozolomide is contraindicated in patients who have a history of hypersensitivity reaction to any of its components. Temozolomide is also contraindicated in patients who have a history of hypersensitivity to DTIC, since both drugs are metabolized to 5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide MTIC).
Valproic Acid: Administration of valproic acid decreases oral clearance of Zolomide by about 5%. The clinical implication of this effect is not known.
Myelosuppression : monitor Absolute Neutrophil Count (ANC) and platelet count prior to dosing and throughout treatment. Geriatric patients and women have a higher risk of developing myelosuppression. Cases of myelodysplastic syndrome and secondary malignancies, including myeloid leukemia, have been observed. Pneumocystis carinii pneumonia (PCP) : prophylaxis required for all patients receiving concomitant Zolomide and radiotherapy for the 42-day regimen for the treatment of newly diagnosed glioblastoma multiforme. All patients, particularly those receiving steroids, should be observed closely for the development of lymphopenia and PCP. Complete blood counts should be obtained throughout the treatment course as specified. Fetal harm can occur when administered to a pregnant woman. Women should be advised to avoid becoming pregnant when receiving Zolomide.