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dacarbazine (Rx)Brand and Other Names:DTIC Dome

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

powder for injection

  • 100mg
  • 200mg
more...

Hodgkin's Disease

With other antineoplastics, eg ABVD

Dosage dependent on protocol

150 mg/m² IV qDay for 5 days, repeat q4Weeks OR 

375 mg/m² IV on Day 1; repeat every 15 Days

Monitor: CBC, LFTs

Metastatic Malignant Melanoma

2-4.5 mg/kg IV qDay for 10 days, repeat q4Weeks OR 

250 mg/m² IV qDay for 5 days, repeat q3Weeks

Monitor: CBC, LFTs

Renal Impairment

CrCl 46-60 mL/min: 80% of regular dose

CrCl 31-45 mL/min: 75% of regular dose

CrCl <30 mL/min: 70% of regular dose

Hepatic Impairment

Not studied; monitor for signs of liver toxicity

Other Indications & Uses

Off-label: Soft-tissue sarcomas, thyroid cancer, neuroblastoma

Dosage Forms & Strengths

powder for injection

  • 100mg
  • 200mg
more...

Hodgkin's Disease

With other antineoplastics, eg ABVD

Dosage dependent on protocol150 mg/m² IV qDay for 5 days, repeat q4Weeks OR 

375 mg/m² IV on Day 1; repeat  every 15 Days

Neuroblastoma Combination Therapy (Off-label)

800-900 mg/m² IV once on day 1; may repeat q3-4weeks 

Hodgkin's Disease

With other antineoplastics, eg ABVD

Dosage dependent on protocol

150 mg/m² IV qDay for 5 days, repeat q4Weeks OR 

375 mg/m² IV on Day 1; repeat  every 15 Days

Monitor: CBC, LFTs

Metastatic Malignant Melanoma

2-4.5 mg/kg IV qDay for 10 days, repeat q4Weeks OR 

250 mg/m² IV qDay for 5 days, repeat q3Weeks

Monitor: CBC, LFTs

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Interactions

Interaction Checker

dacarbazine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Nausea (>90%)

            Vomiting(>90%)

            Injection site pain

            Leukopenia

            Thrombocytopenia

            1-10%

            Alopecia

            Rash

            Photosensitivity

            Anorexia

            Metallic taste

            Flu-like syndrome

            Frequency Not Defined

            Anaphylaxis

            Photosensitivity (rare)

            Cerebral hemorrhage

            Seizure

            Myelosuppression

            Hepatic necrosis

            Hepatic vein thrombosis

            Hepatotoxicity

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            Warnings

            Black Box Warnings

            The drug should be administered under the supervision of an experienced cancer chemotherapy physician.

            The most common toxicity for injectable dacarbazine is hemopoietic (bone marrow) depression

            Hepatic necrosis reported

            Carcinogenic and teratogenic effects reported in animals.

            The physician must weigh the possible therapeutic benefits against the risks of toxicity.

            Contraindications

            Hypersensitivity

            Breastfeeding

            Severe anemia, severe thrombocytopenia

            Cautions

            Caution in hepatic/renal impairment; monitor for toxicity

            May cause severe pain & burning at injection site & along vein; to alleviate, may increase diluent, reduce infusion rate & apply cold compresses

            Risk of potentially fatal hepatocellular necrosis

            Avoid pregnancy

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk, do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Non-cell cycle specific; alkylates DNA & RNA; causes DNA double strand breaks and apoptosis

            Pharmacokinetics

            Half-Life: 5 hr (terminal)

            Peak Plasma: 8 mcg/mL (4.5 mg/kg dose)

            Protein Bound: ~5%

            Vd: 0.6 L/kg

            Metabolism: Liver

            Metabolites: 5-(3-monomethyl-1-triazenyl)-1H-imidazole-4-carboxamide (MIC)

            Excretion: Urine (~40%)

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            Administration

            IV Incompatibilities

            Additive: hydrocortisone sodium succinate

            Y-site: allopurinol, cefepime, piperacillin/tazobactam

            IV Compatibilities

            Solution: D5W(?)

            Additive: ondansetron

            Y-site: amifostine, aztreonam, doxorubicin liposomal, etoposide PO4, filgrastim, fludarabine, granisetron, heparin (at dacarbazine 10 mg/mL; incompatible at 25 mg/mL), melphalan, ondansetron, paclitaxel, sargramostim, teniposide, thiotepa, vinorelbine

            IV Preparation

            Reconstitute with a 9.9 mL (100 mg vial) or 19.7 mL (200 mg vial) of SWI to obtain a 10 mg/mL soln

            For infusion, dilute with D5W or NS up to 250 mL

            IV Administration

            IVP over 1 min (may be irritant & painful) OR infusion over 15-60 min

            Rapid infusion may cause severe venous irritation

            Has also been given intraarterial

            Extravasation Management

            Local pain, burning sensation & irritation at injection site may be relieved by local application of hot packs

            If extravasation occurs, apply cold packs

            Protect exposed tissue from light following extravasation

            Storage

            Store intact vials under refrigeration

            Protect from light

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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