Temozolomide (Temodal®)
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Temozolomide (Temodal®)

  • Monday, 12 October 2009 19:24
  • Last Updated Friday, 25 November 2011 02:12
  1. What is Temozolomide?
  2. Is Temozolomide approved for use in the UK?
  3. How does Temozolomide work?
  4. How is Temozolomide given?
  5. When is Temozolomide given?
  6. Possible side Effects
  7. When to contact your doctor
  8. Monitoring and testing
  9. Additional Information
  10. Published Research
  11. Useful BT Buddies Sections


What is Temozolomide?

Temozolomide is used to treat certain types of Brain Tumour. It is a Chemotherapy drug that works by slowing Cancer cell growth. In some patients, Temozolomide decreases the size of brain tumors. Temozolomide is an oral alkylating agent for the treatment of newly diagnosed Glioblastoma Multiforme and refractory anaplastic astrocytoma.


Is Temozolomide approved for use in the UK?

Temozolomide was approved for use by NICE in June 2007. NICE recommended temozolomide as a possible treatment for people with newly diagnosed glioblastoma multiforme who have a World Health Organization (WHO) performance status of 0 (they are able to carry out all normal activity without restriction) or 1 (they are restricted in strenuous activity but are able to move around and carry out light work).


How does Temozolomide work?

Temozolomide acts directly on the DNA in the cells in your body. DNA controls the growth of normal cells as well as brain Tumor cells. Because these tumor cells grow much faster than normal cells, they are affected to a much greater extent by the effects of Temozolomide Capsules.


How is Temozolomide given?

Temozolomide comes in capsule form and is available in 5mg, 20mg, 100mg and 250mg sizes.

You may be taking Temozolomide along with your Radiotherapy or on it's own. Your neuro-oncologist will discuss your treatment plan with you, each persons regime may vary slightly so the following is for general information purposes only.


When is Temozolomide given?

Temozolomide and Radiotherapy

Radiotherapy is given for 6 weeks Monday to Friday. You should start taking your Temozolomide on the first day that your receive radiotherapy and continue every day including weekends and bank holidays until the final day of radiotherapy.

You should take your Temozolomide about an hour before your radiotherapy session and on the days you do not have radiotherapy you should take your temozolomide first thing in the morning on an empty stomach.

Your specific dose of temozolomide will be based on your height and weight so it may be that you have to take a few capsules at one time to give you the correct dose.

During the 6 weeks you will need to have a blood test every week to check your white blood cells, red cells and platelets.

Whilst you are receiving temozolomide you will also be given an antibiotic to help reduce the risk of infection. Your neuro-oncologist / medical team will give you details on the dose and when to take your antibiotic at the start of your treatment. You may also be prescribed an anti sickness tablet if you are struggling with Nausea and/or vomiting.

Continuing Temozolomide

When you finish your radiotherapy you will be reviewed by your neuro-oncologist who may request you have an MRI scan. Depending on how your treatment has gone and the results of your scan you may then be prescribed Temozolomide for a further 6 months. This will be at a higher dose than before and, again, will be dependent on your height and weight.

You will take the temozolomide for 5 days every 28 days. Before each cycle you will have a blood test and depending on the results you will be given another 5 days supply of Temozolomide.


Possible side Effects

Nausea, vomiting, loss of appetite, constipation, tiredness, weakness, and headache may occur. Nausea and vomiting can be quite severe. Drug therapy may be necessary to prevent or relieve nausea and vomiting. Not eating before your treatment may help relieve vomiting. Changes in diet and lifestyle, such as eating several small meals or limiting activity, may help lessen some of these effects. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Temozolomide because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using Temozolomide) do not have serious side effects.

A very serious allergic reaction to Temodar (temozolomide) is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.


When to contact your doctor

Tell your doctor immediately if any of these unlikely but serious side effects occur: mouth sores, swelling of the ankles/feet, easy bleeding or bruising, shortness of breath.

Temozolomide can lower the body's ability to fight an infection. Notify your doctor promptly if you develop any signs of an infection such as: fever, chills, persistent sore throat, cough, burning/painful/frequent urination.


Monitoring and testing

Patients will have a blood test before having more chemotherapy to make sure that the number of white blood cells doesn't get too low.


Additional Information


Complementary preparations and Supplements

If you are planning to take or are already taking any complementary preparations and supplements you should ask your medical team whether there are any known interactions with Temozolomide.

They can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and supplements may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and supplements, you should tell your medical team immediately.

BT Buddies recommends you thoroughly research any complementary therapies or supplements and discuss in detail your findings with your Neuro-Oncologist or another member of your medical team before adding them to your treatment regime.

Driving and operating machinery

Temozolomide may cause drowsiness. If affected you should not drive or operate machinery.

Family Planning and Pregnancy

The effect of different medicines on a baby in the womb differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Temozolomide:

  • you must not take Temozolomide during pregnancy. If you could become pregnant, you must use effective contraception. You must contact your doctor if you become pregnant, or think you have become pregnant, while taking Temozolomide
  • it is important that you do not father a child while taking this medicine and for at least six months after stopping treatment. You must use effective contraception. If you father a child, your partner must tell her doctor that the baby was conceived while you were taking Temozolomide or within the six months after stopping treatment
  • this medicine may affect your ability to become pregnant or father a child. Before starting treatment you should discuss fertility with your doctor.

You should discuss your personal circumstances with your doctor if you are pregnant or want to become pregnant. This is so that together you can make a decision about what treatment you may need during your pregnancy.

You should also discuss whether there are any other medicines which you could take during pregnancy which would treat your condition.

Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Temozolomide, women who are breast-feeding must not take this medicine

Before you have your baby you should discuss breast-feeding with your doctor or midwife. If you wish to breast-feed you should discuss with your doctor whether there are any other medicines you could take which would also allow you to breast-feed. You should not stop this medicine without taking advice from your doctor.


Published Research

1. NICE Guidance on Temozolomide

2. Further Research and information on Temozolomide


Useful BT Buddies Sections:


The following areas of the BT Buddies website may be useful if you are taking Temozolomide:


Relevant Website Sections
Coping with Fatigue
Nausea and Vomiting
Hairloss
Nutrition
Managing your medication


 

References:

1. www.medicines.org.uk

2. National Institute for Clinical Excellence (NICE)

3. Wikipedia

MEDICAL DISCLAIMER: All the information provided by this website and forum is intended for your general knowledge only and is not a substitute for medical advice or treatment for brain tumours or any other medical conditions. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your doctors. The articles on this website are just the opinions of the authors. We (BT Buddies) do not necessarily agree with the concepts expressed.

Please review any news or information you see on this website with your own Doctor in order to obtain actual medical advice. You should never disregard medical advice or delay in seeking it because of something you have read here.

 


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