decitabine

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.

Availability ⬆ ⬇

(Generic available)

Lyophilized powder for injection: 50 mg/vial
In combination with:
cedazuridine (Inqovi). See Combination Drugs.

Assessment ⬆ ⬇

Monitor for bone marrow depression. Assess for bleeding (bleeding gums, bruising, petechiae, guaiac stools, urine, and emesis) and avoid IM injections and taking rectal temperatures if platelet count is low. Apply pressure to venipuncture sites for 10 min. Assess for signs of infection during neutropenia. If infection occurs delay therapy until resolved. Anemia may occur. Monitor for ↑ fatigue, dyspnea, and orthostatic hypotension.

Lab Test Considerations:

Verify negative pregnancy test before starting therapy.
- Monitor CBC before each dosing cycle and periodically as needed. May cause neutropenia, thrombocytopenia, and anemia; occur more frequently in 1st or 2nd treatment cycles. Use early institution of growth factors and antimicrobial agents to prevent infections. If hematologic recovery (ANC ≥1,000 cells/mm³ and platelets ≥50,000 cells/mm³) from previous treatment cycle requires >6 wk but <8 wk, delay dosing for up to 2 wk and temporarily ↓ dose to 11 mg/m² (33 mg/m²/day, 99 mg/m²/cycle) upon restarting therapy. If hematologic recovery requires >8 wk but <10 wk, assess for disease progression (by bone marrow aspirates); in the absence of progression, delay dose for up to 2 more wk and ↓ dose as above upon restarting, then maintain or ↑ in subsequent cycles as clinically indicated.
- Obtain liver function tests before starting therapy. May cause hyperbilirubinemia and hypoalbuminemia. If ALT or total bilirubin ≥2 times upper limit of normal, delay therapy until return to normal.
- Obtain creatinine before starting therapy. If creatinine ≥2 mg/dL, delay therapy until return to normal.
- May cause hyperglycemia, hypomagnesemia, hyponatremia, hypokalemia, and hyperkalemia.

Implementation ⬆ ⬇

High Alert: Fatalities have occurred with chemotherapeutic agents. Before administering, clarify all ambiguous orders; double-check single, daily, and course-of-therapy dose limits; have second practitioner independently double-check original order, calculations, and infusion pump settings.
- Premedicate patient with standard antiemetic therapy.

IV Administration:

When preparing, wear double chemotherapy gloves, protective gown, respiratory (N95) protection, and hair and shoe covers; optimally prepare in a ventilated control device. When administering, add eye/face protection if there is a potential that the substance could splash. Use a closed system drug-transfer device when dosage form allows. Discard IV equipment in specially designated containers. Discard IV equipment in specially designated containers.
Intermittent Infusion: Reconstitution: Reconstitute with 10 mL of sterile water for injection.Concentration: 5 mg/mL.Diluent: Further dilute reconstituted solution with 0.9% NaCl or D5W.Concentration: 0.1–1 mg/mL. If diluted with room temperature solutions, infuse within 15 min. If diluted using cold fluids, may refrigerate for no more than 4 hr until administration. Do not infuse solutions that are discolored or contain particulate matter.
Rate: Administer over 3 hr or over 1 hr, depending on treatment regimen chosen.
Y-Site Compatibility:
- alemtuzumab
- amifostine
- amikacin
- amiodarone
- anidulafungin
- argatroban
- arsenic trioxide
- atracurium
- bivalirudin
- bleomycin
- bumetanide
- buprenorphine
- butorphanol
- calcium chloride
- calcium gluconate
- carboplatin
- carmustine
- caspofungin
- chlorpromazine
- ciprofloxacin
- cisatracurium
- cisplatin
- cyclophosphamide
- cyclosporine
- cytarabine
- dacarbazine
- dactinomycin
- daptomycin
- dexmedetomidine
- dexrazoxane
- digoxin
- diltiazem
- diphenhydramine
- dobutamine
- docetaxel
- dopamine
- doxycycline
- droperidol
- enalaprilat
- ephedrine
- epinephrine
- erythromycin
- esmolol
- etoposide
- etoposide phosphate
- famotidine
- fentanyl
- filgrastim
- fluconazole
- gemcitabine
- gentamicin
- glycopyrrolate
- granisetron
- haloperidol
- hetastarch
- hydralazine
- hydrocortisone
- hydromorphone
- idarubicin
- imipenem/cilastatin
- insulin regular
- irinotecan
- isoproterenol
- labetalol
- leucovorin calcium
- lidocaine
- linezolid
- lorazepam
- magnesium sulfate
- mannitol
- melphalan
- meperidine
- meropenem
- methotrexate
- metoclopramide
- metoprolol
- midazolam
- milrinone
- mitomycin
- morphine
- moxifloxacin
- nalbuphine
- naloxone
- nitroglycerin
- norepinephrine
- octreotide
- ondansetron
- oxaliplatin
- paclitaxel
- palonosetron
- pentamidine
- phentolamine
- phenylephrine
- potassium acetate
- potassium chloride
- potassium phosphate
- procainamide
- prochlorperazine
- promethazine
- propranolol
- remifentanil
- rituximab
- sodium acetate
- sodium bicarbonate
- sodium phosphate
- succinylcholine
- sufentanil
- tacrolimus
- theophylline
- thiotepa
- tigecycline
- tobramycin
- topotecan
- trastuzumab
- vancomycin
- vecuronium
- verapamil
- vinblastine
- vincristine
- vinorelbine
- voriconazole
- zidovudine
- zoledronic acid
Y-Site Incompatibility:
- acyclovir
- allopurinol
- aminophylline
- amphotericin B lipid complex
- amphotericin B liposomal
- ampicillin
- ampicillin/sulbactam
- aztreonam
- cefazolin
- cefepime
- cefotaxime
- cefotetan
- cefoxitin
- ceftazidime
- ceftriaxone
- cefuroxime
- chloramphenicol
- clindamycin
- dantrolene
- dexamethasone
- diazepam
- ertapenem
- fludarabine
- foscarnet
- fosphenytoin
- furosemide
- ganciclovir
- heparin
- ketorolac
- levofloxacin
- methohexital
- methylprednisolone
- mitoxantrone
- nafcillin
- nitroprusside
- pantoprazole
- pentobarbital
- phenobarbital
- phenytoin
- trimethoprim/sulfamethoxazole

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of decitabine. Do not stop receiving drug without consulting health care provider. If an appointment is missed, reschedule as soon as possible. Advise patient to read Medication Guide before starting and periodically during therapy in case of changes.
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).
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: May cause fetal harm. Advise women 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.

Evaluation/Desired Outcomes ⬆ ⬇

Improved hematologic and clinical manifestations of myelodysplastic syndromes.

US Brand Names ⬆ ⬇

Canadian Brand Names ⬆ ⬇

Code ⬆

NDC Code

0143- Hikma Pharmaceuticals USA Inc.
- 0143-9385- decitabine
  - 0143-9385-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (0143-9385-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE

16729- Accord Healthcare Inc.
- 16729-224- Decitabine
  - 16729-224-05- 1 VIAL in 1 CARTON (16729-224-05) / 20 mL in 1 VIAL

17404- Farmhispania S.A.
- 17404-1029-
  - 17404-1029-1- 1 BAG in 1 DRUM (17404-1029-1) / 4 kg in 1 BAG

25021- Sagent Pharmaceuticals
- 25021-219- Decitabine
  - 25021-219-20- 1 VIAL in 1 CARTON (25021-219-20) / 20 mL in 1 VIAL

31722- Camber Pharmaceuticals, Inc.
- 31722-304- Decitabine
  - 31722-304-31- 1 VIAL, SINGLE-DOSE in 1 CARTON (31722-304-31) / 10 mL in 1 VIAL, SINGLE-DOSE

43598- Dr. Reddy's Laboratories Inc.
- 43598-348- Decitabine
  - 43598-348-37- 1 VIAL, SINGLE-USE in 1 CARTON (43598-348-37) / 10 mL in 1 VIAL, SINGLE-USE

43598- Dr. Reddy's Laboratories Inc.
- 43598-427- Decitabine
  - 43598-427-37- 1 VIAL, SINGLE-USE in 1 CARTON (43598-427-37) / 10 mL in 1 VIAL, SINGLE-USE

47335- Sun Pharmaceutical Industries, Inc.
- 47335-361- decitabine
  - 47335-361-41- 1 KIT in 1 CARTON (47335-361-41) * 10 mL in 1 VIAL, SINGLE-DOSE * 10 mL in 1 VIAL (47335-362-40)

50137- Veranova, L.P.
- 50137-4147-
  - 50137-4147-1- 1 kg in 1 CONTAINER (50137-4147-1)

50742- Ingenus Pharmaceuticals, LLC
- 50742-430- DECITABINE
  - 50742-430-01- 1 VIAL in 1 CARTON (50742-430-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

51916- Wuhan Biocause Pharmaceutical Development Co., Ltd
- 51916-360-
  - 51916-360-01- 100 g in 1 BOTTLE, GLASS (51916-360-01)

54245- SciAnda (Changshu) Pharmaceuticals, Ltd.
- 54245-7035-
  54245-7035-0- 500 g in 1 BAG (54245-7035-0)

54893- MSN Laboratories Private Limited
- 54893-0056-
  54893-0056-6- 3 kg in 1 DRUM (54893-0056-6)

55111- Dr.Reddy's Laboratories Limited
- 55111-556- Decitabine
  55111-556-10- 1 VIAL, SINGLE-USE in 1 CARTON (55111-556-10) / 10 mL in 1 VIAL, SINGLE-USE

55111- Dr. Reddy's Laboratories Limited
- 55111-915-
  - 55111-915-00- 1 kg in 1 DRUM (55111-915-00)

55150- Eugia US LLC
- 55150-376- Decitabine
  55150-376-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (55150-376-01) / 26 mL in 1 VIAL, SINGLE-DOSE

63323- Fresenius Kabi USA, LLC
- 63323-825- Decitabine
  - 63323-825-20- 1 VIAL, SINGLE-DOSE in 1 CARTON (63323-825-20) / 20 mL in 1 VIAL, SINGLE-DOSE

65129- ScinoPharm Taiwan Ltd.
- 65129-1223-
  - 65129-1223-0- 1.5 kg in 1 BAG (65129-1223-0)

65129- ScinoPharm Taiwan Ltd.
- 65129-1223-
  65129-1223-1- 1.5 kg in 1 BAG (65129-1223-1)

66529- Jiangsu Hansoh Pharmaceutical Group Co., Ltd.
- 66529-0007-
  66529-0007-1- 1400 g in 1 BAG (66529-0007-1)

67184- Qilu Pharmaceutical Co., Ltd.
- 67184-0535- Decitabine
  67184-0535-1- 1 VIAL in 1 CARTON (67184-0535-1) / 20 mL in 1 VIAL

67430- Pfanstiehl, Inc.
- 67430-275-
  - 67430-275-18- 1 BAG in 1 DRUM (67430-275-18) / 1.8 kg in 1 BAG

67457- Mylan Institutional LLC
- 67457-316- Decitabine
  67457-316-25- 1 VIAL in 1 CARTON (67457-316-25) / 20 mL in 1 VIAL

68001- BluePoint Laboratories
- 68001-573- DECITABINE
  - 68001-573-41- 1 VIAL in 1 CARTON (68001-573-41) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

68001- BluePoint Laboratories
- 68001-618- Decitabine
  - 68001-618-37- 1 VIAL in 1 CARTON (68001-618-37) / 20 mL in 1 VIAL

68001- BluePoint Laboratories
- 68001-642- Decitabine
  - 68001-642-41- 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-642-41) / 10 mL in 1 VIAL, SINGLE-DOSE

68083- Gland Pharma Limited
- 68083-528- decitabine
  - 68083-528-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (68083-528-01) / 10 mL in 1 VIAL, SINGLE-DOSE

69539- MSN LABORATORIES PRIVATE LIMITED
- 69539-115- Decitabine
  - 69539-115-01- 1 VIAL, SINGLE-USE in 1 CARTON (69539-115-01) / 20 mL in 1 VIAL, SINGLE-USE

70121- Amneal Pharmaceuticals LLC
- 70121-1644- Decitabine
  - 70121-1644-1- 1 VIAL, SINGLE-USE in 1 CARTON (70121-1644-1) / 20 mL in 1 VIAL, SINGLE-USE

70747- Wuhan Calmland Pharmaceuticals Co., Ltd.
- 70747-1005-
  - 70747-1005-1- 1 BAG in 1 DRUM (70747-1005-1) / 1000 mg in 1 BAG

71288- Meitheal Pharmaceuticals Inc.
- 71288-119- Decitabine
  71288-119-20- 1 VIAL, SINGLE-DOSE in 1 CARTON (71288-119-20) / 20 mL in 1 VIAL, SINGLE-DOSE

71288- Meitheal Pharmaceuticals Inc.
- 71288-119- Decitabine
  - 71288-119-91- 1 VIAL, SINGLE-DOSE in 1 CARTON (71288-119-91) / 20 mL in 1 VIAL, SINGLE-DOSE

72205- Novadoz Pharmaceuticals LLC
- 72205-031- Decitabine
  - 72205-031-01- 1 VIAL, SINGLE-USE in 1 CARTON (72205-031-01) / 20 mL in 1 VIAL, SINGLE-USE

72205- Novadoz Pharmaceuticals LLC
- 72205-036- Decitabine
  - 72205-036-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (72205-036-01) / 10 mL in 1 VIAL, SINGLE-DOSE

72603- Northstar Rx LLC
- 72603-107- Decitabine
  - 72603-107-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (72603-107-01) / 10 mL in 1 VIAL, SINGLE-DOSE

75834- Nivagen Pharmaceuticals, Inc.
- 75834-190- DECITABINE
  - 75834-190-01- 1 VIAL in 1 CARTON (75834-190-01) / 20 mL in 1 VIAL

76055- Sionc Pharmaceutical Private Limited
- 76055-0018-
  - 76055-0018-1- 25 kg in 1 DRUM (76055-0018-1)

82920- SHILPA PHARMA LIFESCIENCES LIMITED
- 82920-016-
  82920-016-00- 500 g in 1 DRUM (82920-016-00)

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇