captivated with [3000/mm:<100,000/mm 3 ) may require temporary withdrawal or discontinuance of the drug. 100 b Hepatic Effects Hepatotoxicity complicated by hepatic vein thrombosis and hepatocellular necrosis resulting in death has been reported. 100 More common with combination regimens but also occurs with dacarbazine alone. 100 Fetal/Neonatal Morbidity and Mortality May cause fetal harm; teratogenicity and embryolethality demonstrated in animals. 100 Sensitivity Reactions Hypersensitivity Reactions Possible hypersensitivity reactions, including anaphylaxis. 100 Photosensitivity Photosensitivity reactions reported rarely. 100 General Precautions Carcinogenicity Carcinogenic effects reported in animals; importance in humans not known. 100 b Local Effects Extravasation may result in tissue damage and severe pain. 100 Undiluted solutions administered by IV injection may cause severe pain and phlebitis; some clinicians recommend dilution and infusion. b Hot packs may relieve local pain, burning sensation, and irritation at the injection site. 100 Specific Populations Pregnancy Category C. 100 Lactation Not known whether dacarbazine is distributed into milk; discontinue nursing or the drug. 100 Common Adverse Effects Anorexia, nausea, vomiting, leukopenia, thrombocytopenia. 100 Interactions for DTIC-Dome Metabolized by hepatic microsomal enzymes. b Drugs Affecting Hepatic Microsomal Enzymes Enzyme inducers: Possible increased metabolism of dacarbazine. b Specific Drugs Drug Interaction Phenobarbital Possible increased dacarbazine metabolism b Phenytoin Possible increased dacarbazine metabolism b DTIC-Dome Pharmacokinetics Absorption Bioavailability Poorly absorbed from the GI tract. b Distribution Extent Volume of distribution exceeds total body water content, suggesting localization in a body tissue, probably the liver. 100 Crosses blood-brain barrier to a limited extent; CSF concentrations approximately 14% of plasma concentrations. 100 Not known whether dacarbazine crosses the placenta or is distributed into milk. 100 Plasma Protein Binding Slightly bound. 100 Elimination Metabolism Extensively metabolized; hepatic microsomal enzymes are involved. 100 b Some metabolites may contribute to the antineoplastic effect of the drug. b Elimination Route Excreted in urine by tubular secretion; about 46% of an administered dose is excreted in urine within 6 hours (about 50% as unchanged drug and 50% as 5-amino-1 H -imidazole-4-carboxamide [AIC]). (See Actions.) 100 b Half-life Biphasic; initial-phase half-life averages 19 minutes; terminal half-life averages 5 hours. 100 Stability Storage Parenteral Powder for Injection 2 8 C; protect from light. 100 Use reconstituted solutions containing 10 mg/mL in sterile water for injection within 8 hours if stored at room temperature or 72 hours if stored at 4 C. 100 d Use solutions further diluted with 500 mL of 5% dextrose or 0.9% sodium chloride injection within 8 hours if stored at room temperature or 24 hours if stored at 4 C. 100 b d Compatibility For information on systemic interactions resulting from concomitant use, see Interactions. Parenteral Solution Compatibility Variable Dextrose 5% in water HID Sodium chloride 0.9% b Drug Compatibility Admixture CompatibilityHID Compatible Ondansetron HCl Variable Ondansetron HCl with doxorubicin HCl Incompatible Hydrocortisone sodium succinate b Y-Site CompatibilityHID Compatible Amifostine Aztreonam Doxorubicin HCl liposome injection Etoposide phosphate Filgrastim Fludarabine phosphate Granisetron HCl Melphalan HCl Ondansetron HCl Paclitaxel Palonosetron HCl Sargramostim Teniposide Thiotepa Vinorelbine tartrate Incompatible Allopurinol sodium Hydrocortisone sodium succinate Piperacillin sodium tazobactam sodium Variable Heparin sodium Actions Appears to exert cytotoxic effect by acting as an alkylating agent. 100 Does not exhibit cell cycle-phase specificity. b Synthetic analog of naturally occurring purine precursor 5-amino-1 H -imidazole-4-carboxamide (AIC). 100 Advice to Patients Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 100 Importance of informing patients of other important precautionary information. (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. * available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name Dacarbazine Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral For injection, for IV use 100 mg* Dacarbazine for Injection 200 mg* Dacarbazine for Injection DTIC-Dome Bayer AHFS DI Essentials. Copyright 2017, Selected Revisions June 20, 2013. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Use is not currently included in the labeling approved by the US Food and Drug Administration. References Only references cited for selected revisions after 1984 are available electronically. 100. Bayer Corporation. DTIC-Dome (dacarbazine) prescribing information. West Haven, CT; 1998 Sep. 101. Anon. Drugs of choice for cancer chemotherapy. Med Lett Drugs Ther . 2000; 42:83-92. [PubMed 10994034] 102. Urba WJ, Longo DL. Hodgkin s disease. N Engl J Med . 1992; 326:678-687. [PubMed 1736106] 103. DeVita VT Jr, Hubbard SM. Hodgkin s disease. N Engl J Med . 1993; 328:560-5. [PubMed 8426624] 104. Adult Hodgkin s disease. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Sep. 105. Melanoma. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Jun. 106. Duran Garcia E, Santolaya R, Requena T. Treatment of malignant melanoma. Ann Pharmacother . 1999; 33:730-8. [PubMed 10410188] 107. Cohen GL, Falkson CI. Current treatment options for malignant melanoma. Drugs . 1998; 55:791-9. [PubMed 9617594] 108. Houghton A, Coit D, Bloomer W et al. NCCN melanoma practice guidelines. National Comprehensive Cancer Network. Oncology (Huntingt) . 1998; 12:153-77. 109. Agarwala SS, Ferri W, Gooding W et al. A phase III randomized trial of dacarbazine and carboplatin with and without tamoxifen in the treatment of patients with metastatic melanoma. Cancer . 1999; 85:1979-84. [PubMed 10223239] 110. Rosenberg SA, Yang JC, Schwartzentruber DJ et al. Prospective randomized trial of the treatment of patients with metastatic melanoma using chemotherapy with cisplatin, dacarbazine, and tamoxifen alone or in combination with interleukin-2 and interferon alfa-2b. J Clin Oncol . 1999; 17:968-75. [PubMed 10071291] 111. Falkson CI, Ibrahim J, Kirkwood JM et al. Phase III trial of dacarbazine versus dacarbazine with interferon alpha-2b versus dacarbazine with tamoxifen versus dacarbazine with interferon alpha-2b and tamoxifen in patients with metastatic malignant melanoma: an Eastern Cooperative Oncology Group study. J Clin Oncol . 1998; 16:1743-51. [PubMed 9586887] 112. Jungnelius U, Ringborg U, Aamdal S et al. Dacarbazine-vindesine versus dacarbazine-vindesine-cisplatin in disseminated malignant melanoma. A randomised phase III trial. Eur J Cancer . 1998; 34:1368-74. [PubMed 9849419] 113. Johnston SR, Constenla DO, Moore J et al. Randomized phase II trial of BCDT [carmustine (BCNU), cisplatin, dacarbazine (DTIC) and tamoxifen] with or without interferon alpha (IFN-alpha) and interleukin (IL-2) in patients with metastatic melanoma. Br J Cancer . 1998; 77:1280-6. [PubMed 9579834] 114. Legha SS, Ring S, Bedikian A et al. Treatment of metastatic melanoma with combined chemotherapy containing cisplatin, vinblastine and dacarbazine (CVD) and biotherapy using interleukin-2 and interferon-alpha. Ann Oncol . 1996; 7:827-35. [PubMed 8922197] 115. Rusthoven JJ, Quirt IC, Iscoe NA et al. Randomized, double-blind, placebo-controlled trial comparing the response rates of carmustine, dacarbazine, and cisplatin with and without tamoxifen in patients with metastatic melanoma. National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol . 1996; 14:2083-90. [PubMed 8683240] 116. Cocconi G, Bella M, Calabresi F et al. Treatment of metastatic malignant melanoma with dacarbazine plus tamoxifen. N Engl J Med . 1992; 327:516-23. [PubMed 1635566] 117. Guerry IV D, Schuchter LM. Disseminated melanoma is there a new standard therapy? N Engl J Med . 1992; 327:560-1. Editorial. 118. Margolin KA, Liu PY, Flaherty LE et al. Phase II study of carmustine, dacarbazine, cisplatin, and tamoxifen in advanced melanoma: a Southwest Oncology Group study. J Clin Oncol . 1998; 16:664-9. [PubMed 9469356] 119. Balch CM, Buzaid AC. Finally, a successful adjuvant therapy for high-risk melanoma. J Clin Oncol . 1996; 14:1-3. [PubMed 8558183] 120. Cole BF, Gelber RD, Kirkwood JM et al. Quality-of-life-adjusted survival analysis of interferon alfa-2b adjuvant treatment of high-risk resected cutaneous melanoma: an Eastern Cooperative Oncology Group study. J Clin Oncol . 1996; 14:2666-73. [PubMed 8874325] 121. Haluska FG. Adjuvant interferon for stage II melanoma. J Clin Oncol . 1998; 16:3205-6. [PubMed 9738597] 122. Kirkwood JM. Adjuvant IFNα2 therapy of melanoma. Lancet . 1998; 351:1901-3. [PubMed 9654253] 123. Ascierto PA, Palmieri G. Adjuvant therapy of cutaneous melanoma. Lancet . 1999; 353:328. [PubMed 9929057] 124. Kirkwood JM, Ibrahim J, Sondak V et al. Preliminary analysis of the E1690/S9111/C9190 Intergroup postoperative adjuvant trial of high- and low-dose IFNa2b (HDI and LDI) in high-risk primary or lymph node metastatic melanoma. Proc Am Soc Clin Oncol . 1999; 18:A2072. 125. Bajetta E, Di Leo A, Zampino MG et al. Multicenter randomized trial of dacarbazine alone or in combination with two different doses and schedules of interferon alfa-2a in the treatment of advanced melanoma. J Clin Oncol . 1994; 12:806-11. [PubMed 8151323] 126. Thomson DB, Adena M, McLeod GR et al. Interferon-alpha 2a does not improve response or survival when combined with dacarbazine in metastatic malignant melanoma: results of a multi-institutional Australian randomized trial. Melanoma Res . 1993; 3:133-8. [PubMed 8518552] 127. Falkson CI, Falkson G, Falkson HC Improved results with the addition of interferon alfa-2b to dacarbazine in the treatment of patients with metastatic malignant melanoma. J Clin Oncol . 1991; 9:1403-8. 128. Koops HS, Vaglini M, Suciu S et al. Prophylactic isolated limb perfusion for localized, high-risk limb melanoma: results of a multicenter randomized phase III trial. European Organization for Research and Treatment of Cancer Malignant Melanoma Cooperative Group Protocol 18832, the World Health Organization Melanoma Program Trial 15, and the North American Perfusion Group Southwest Oncology Group-8593. J Clin Oncol . 1998; 16:2906-12. [PubMed 9738557] 129. Tan JK, Ho VC. Pooled analysis of the efficacy of bacille Calmette-Guerin (BCG) immunotherapy in malignant melanoma. J Dermatol Surg Oncol . 1993; 19:985-90. [PubMed 8245304] 130. Wallack MK, Sivanandham M, Balch CM et al. Surgical adjuvant active specific immunotherapy for patients with stage III melanoma: the final analysis of data from a phase III, randomized, double-blind, multicenter vaccinia melanoma oncolysate trial. J Am Coll Surg . 1998; 187:69-79. [PubMed 9660028] 131. Hafstrom L, Rudenstam CM, Blomquist E et al. Regional hyperthermic perfusion with melphalan after surgery for recurrent malignant melanoma of the extremities. Swedish Melanoma Study Group. J Clin Oncol . 1991; 9:2091-4. [PubMed 1960549] 132. Quirt IC, Shelley WE, Pater JL et al. Improved survival in patients with poor-prognosis malignant melanoma treated with adjuvant levamisole: a phase III study by the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol . 1991; 9:729-35. [PubMed 2016615] 133. Spitler LE. A randomized trial of levamisole versus placebo as adjuvant therapy in malignant melanoma. J Clin Oncol . 1991; 9:736-40. [PubMed 2016616] 134. Creagan ET, Suman VJ, Dalton RJ et al. Phase III clinical trial of the combination of cisplatin, dacarbazine, and carmustine with or without tamoxifen in patients with advanced malignant melanoma. J Clin Oncol . 1999; 17:1884-90. [PubMed 10561229] 135. Chapman PB, Einhorn LH, Meyers ML et al. Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol . 1999; 17:2745-51. [PubMed 10561349] 136. Legha SS, Ring S, Eton O et al. Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa, and interleukin-2 for patients with metastatic melanoma. J Clin Oncol . 1998; 16:1752-9. [PubMed 9586888] 137. Atkins MB, Flaherty LE, Sosman JA, principal investigators. Phase III study of concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b versus cisplatin, vinblastine, and dacarbazine alone in patients with metastatic malignant melanoma (summary last modified 10/1999). Protocol ID: E-E3695. From CancerNet: PDQ Clinical Trials (database). Bethesda, MD: National Cancer Institute; accessed 1999 Nov 29. 138. Reviewers comments (personal observations) on melanoma. 139. Kirkwood JM, Strawderman MH, Ernstoff MS et al. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol . 1996; 14:7-17. [PubMed 8558223] HID. Trissel LA. Handbook on injectable drugs. 17th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2013:327-9. b. AHFS Drug Information 2004. McEvoy GK, ed. Dacarbazine. American Society of Health-System Pharmacists; 2004: 956-8. c. Bayer Corporation. DTIC-Dome (dacarbazine) prescribing information. West Haven, CT; 2003 May. d. American Pharmaceutical Partners. Dacarbazine (for injection) prescribing information. Schaumburg, Illinois; 2002 April. Next Interactions Print this page Add to My Med List More about DTIC-Dome (dacarbazine) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: alkylating agents Consumer resources Dtic-Dome Dtic-Dome (Advanced Reading) Professional resources Dacarbazine (AHFS Monograph) Dacarbazine (FDA) Related treatment guides Hodgkin's Lymphoma Melanoma Melanoma, Metastatic> ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Alkylating agents Related Drugs Hodgkin's Lymphoma Opdivo , Keytruda , cyclophosphamide , nivolumab , Cytoxan , etoposide , Adriamycin , doxorubicin , More... Melanoma, Metastatic Opdivo , Keytruda , nivolumab , pembrolizumab , Yervoy , ipilimumab , Tafinlar , Mekinist , More... Melanoma Opdivo , Keytruda , nivolumab , pembrolizumab , Yervoy , ipilimumab , Proleukin , dacarbazine , More... DTIC-Dome Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } earn a living from home
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