decitabine

Contraindicated in:

Hypersensitivity;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Renal impairment;
Hepatic impairment;
Rep: Women of reproductive potential and men with female partners of reproductive potential;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults may be more sensitive to effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: atrial fibrillation, pulmonary edema, tachycardia

Derm: petechiae, rash

EENT: blurred vision

F and E: edema, hypokalemia, hypomagnesemia, ascites

GI: abdominal pain, constipation, diarrhea, stomatitis, vomiting, ↑liver enzymes

GU: ↓fertility (males)

Hemat: anemia, neutropenia, thrombocytopenia, BLEEDING

Local: injection site irritation

Metab: hyperglycemia

MS: arthralgia, myalgia

Neuro: confusion, fatigue, insomnia, depression, lethargy

Resp: cough

Misc: fever, INFECTION, lymphadenopathy

Interactions ⬆ ⬇

Drug-drug:

↑risk of myelosuppression with other antineoplastics, immunosuppressants, or radiation therapy.
May ↓ antibody response to and ↑ risk of adverse reactions from live virus vaccines.

Availability ⬆ ⬇

(Generic available)

Lyophilized powder for injection: 50 mg/vial
In combination with: cedazuridine (Inqovi). See Appendix [not included in this PDA edition].

Route/Dosage ⬆ ⬇

IV (Adults ): 15 mg/m² every 8 hr for 3 days; cycle should be repeated every 6 wk for a minimum of 4 cycles or 20 mg/m² once daily for 5 days; cycle should be repeated every 4 wk for a minimum of 4 cycles.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits DNA methyltransferase, causing apoptosis. Has more effect on rapidly replicating cells.

Therapeutic effects:

Improved hematologic and clinical manifestations of MDS.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized by the liver.

Half-Life: 0.5 hr.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(blood levels)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose of decitabine to patient.
Caution patient to avoid crowds and persons with known infections. Report symptoms of infection (fever, chills, cough, hoarseness, sore throat, lower back or side pain, painful or difficult urination) immediately.
Instruct patient to report unusual bleeding. Advise patient of thrombocytopenia precautions (use soft toothbrush and electric razor, avoid falls, do not drink alcoholic beverages or take medication containing aspirin or NSAIDs; may precipitate gastric bleeding).
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during and for 6 mo after last dose and to avoid breastfeeding during and for 1 wk after last dose. Advise men with female partners of reproductive potential to use effective contraception during and for 3 mo after last dose. May impair male fertility.

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Indications ⬇

Contraind./Precautions ⬆ ⬇