Temozolomide (Generic Name)

Other Names: Temodar®

About This Drug

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

Possible Side Effects (More Common)

  • Headache
  • Tiredness
  • Constipation (not able to move bowels)
  • 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.
  • 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.

Possible Side Effects (Less Common)

  • Feeling dizzy
  • Loose bowel movements (diarrhea) that may last for a few days

Allergic Reactions

  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If you get these symptoms, tell your doctor or get medical treatment right away.
  • If you are taking this drug by mouth (pill or capsule) and you have these symptoms, do not take another dose of this drug unless your doctor tells you it is okay. You should get medical treatment right away.

Treating Side Effects

  • 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
  • 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.
  • Ask your doctor or nurse about medicine that is available to help stop or lessen the loose bowel movements.

Important Information

  • You can take the medicine with or without food.  If you have nausea, take it without food or at bedtime.
  • Swallow the medicine whole.  Do not chew, break or crush it.
  • Do not take any capsules that are broken, opened, or damaged. If your skin or mouth comes in contact with the powder from these capsules, clean them with water right away.
  • Take this medicine at the same time each day with a full glass of water
  • Missed dose: If you miss a dose of this drug, call your doctor right away for further direction

Food and Drug Interactions

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

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 higher
  • Chills
  • Seizures
  • Easy bleeding or bruising
  • 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 lightheadedness
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • 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.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause.  If you have any of these symptoms for 2 minutes, call 911. 
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • No bowel movement in 3 days or when you feel uncomfortable.
  • Loose bowel movements (diarrhea) 4  times or loose bowel movements with lack of strength or a feeling of being dizzy
  • Change in hearing, ringing in the ears
  • Blurred vision or other changes in eyesight
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • 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
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • 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 August 2015

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