Temozolomide (Temodar®)

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About This Drug

Temozolomide is used to treat cancer. It is given orally (by mouth) and by the vein (IV).

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Viral infection
  • Fever
  • Feeling dizzy
  • Headache
  • Weakness on one side of the body
  • Loss of coordination
  • Seizure. Common symptoms of a seizure can include confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin
  • Tiredness
  • Weakness
  • Trouble sleeping
  • Memory loss
  • Decreased appetite (decreased hunger)
  • Nausea and throwing up (vomiting)
  • Constipation
  • Loose bowel movements (diarrhea)
  • Rash

Note: Each of the side effects above was reported in 10% or greater of patients treated with temozolomide. Not all possible side effects are included above.

Warnings and Precautions

  • Severe bone marrow depression which can be life-threatening
  • This drug may raise your risk of getting a second cancer such as leukemia
  • Changes in your liver function, which can cause liver failure and be life-threatening
  • Respiratory infection such as pneumonia

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

How to Take Your Medication

  • For oral: Swallow the medicine whole with water, consistently with or without food. If you have nausea, take it without food or at bedtime. Do not chew, or open capsules.
  • Take this medicine at the same time each day.
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time. Do not take 2 doses at the same time, instead, continue with your regular dosing schedule and contact your physician.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • If any of the capsules are broken, do not touch them with bare hands. Carefully throw away the capsules and wash your hands after handling.
  • If you get any of the content of a broken capsules on your skin, you should wash the area of the skin well with soap and water right away. Call your doctor if you get a skin reaction
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • If you are dizzy, get up slowly after sitting or lying.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with decreased appetite, eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • There are no known interactions of temozolomide with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with temozolomide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Headache that does not go away
  • Memory loss
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • You cough up yellow, green, or bloody mucus
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • No bowel movement in 3 days or when you feel uncomfortable
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Symptoms of a seizure such as confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. If you or your family member suspects you are having a seizure, call 911 right away.
  • Weakness on one side of your body
  • Loss of coordination
  • A new rash or a rash that is not relieved by prescribed medicines
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.Ask for information on sperm or egg banking.

Revised January 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.