Decitabine (generic name)

Other names: Dacogen®

About this drug

This drug is used to treat bone marrow disorders and leukemia. It is given in 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 for infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Fever
  • Generalized weakness and discomfort
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
  • Changes in bowel movements. Some patients have loose bowel movements (diarrhea) that may last for a few days. Other patients have constipation (not able to move bowels).
  • Decreased appetite (decreased hunger)
  • Electrolyte changes.  Your blood will be checked for electrolyte changes as needed.
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function. You blood work will be checked by your doctor.
  • Cough
  • Swelling of your legs, ankles, and/or feet
  • Feeling short of breath
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • High blood sugar (hyperglycemia). You may feel very thirsty and need to urinate often.
  • Feeling dizzy
  • Trouble sleeping
  • Hair loss. You may notice hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
  • Joint pain
  • Rash
  • Tiny red spots on the arms and legs
  • Bruising
  • Fatigue
  • Weakness that interferes with your daily activities
  • Headache

Treating side effects

  • Ask your doctor or nurse about medicines to help stop or lessen nausea, throwing up, loose bowel movements, constipation, headache, or joint pain.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. 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).
  • If you are dizzy, get up slowly after sitting or lying down.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if the rash bothers you.
  • Let your doctor or nurse know if you are having trouble sleeping.

Food and drug interactions

There are no known interactions of decitabine with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain in your lower back or side
  • Confusion or agitation
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, bad tiredness or weakness, unusual itching, or yellowing of the eyes or skin.
  • Tiny red spots on your arms and legs

Notify your doctor or nurse as soon as possible if you have any of these symptoms:

  • Nausea, throwing up, loose bowel movements, constipation, rash, headache, joint paint, or trouble sleeping that does not get better when you take prescribed medications.
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Swelling of legs, ankles, or feet
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

If you have diabetes

If you have diabetes, tell the doctor who treats your blood sugar that you are receiving cancer treatment. If you check your blood sugar and it is high, call your doctor for further instructions.

Reproductive concerns

  • Pregnancy warning:  This drug may have harmful effects on the unborn child, so effective methods of birth control should be used by both you and your partner during your cancer treatment and for at least 2 months after treatment is done.
    Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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