Dosing & Uses
Dosage Forms & Strengths
powder for injection
- 100mg
- 200mg
Hodgkin Lymphoma
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
Hodgkin Lymphoma
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)
Hodgkin Lymphoma
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (13)
- adenovirus types 4 and 7 live, oral
dacarbazine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.
- axicabtagene ciloleucel
dacarbazine, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- brexucabtagene autoleucel
dacarbazine, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ciltacabtagene autoleucel
dacarbazine, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.
- idecabtagene vicleucel
dacarbazine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- influenza virus vaccine quadrivalent, adjuvanted
dacarbazine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.
- influenza virus vaccine trivalent, adjuvanted
dacarbazine decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.
- lisocabtagene maraleucel
dacarbazine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- palifermin
palifermin increases toxicity of dacarbazine by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b, dacarbazine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tisagenlecleucel
dacarbazine, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- tofacitinib
dacarbazine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
Monitor Closely (34)
- acalabrutinib
acalabrutinib, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.
- belatacept
belatacept and dacarbazine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.
- bendamustine
bendamustine, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- busulfan
busulfan, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- cannabidiol
cannabidiol, dacarbazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.
- carboplatin
carboplatin, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- carmustine
carmustine, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- chlorambucil
chlorambucil, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- cholera vaccine
dacarbazine decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.
- cisplatin
cisplatin, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- cyclophosphamide
cyclophosphamide, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- deferasirox
deferasirox increases levels of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- dengue vaccine
dacarbazine decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- denosumab
dacarbazine, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.
- fexinidazole
fexinidazole will increase the level or effect of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- fingolimod
dacarbazine increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .
- hydroxyurea
dacarbazine, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.
- ifosfamide
dacarbazine, ifosfamide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- influenza A (H5N1) vaccine
dacarbazine decreases effects of influenza A (H5N1) vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.
- influenza virus vaccine (H5N1), adjuvanted
dacarbazine decreases effects of influenza virus vaccine (H5N1), adjuvanted by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.
- isavuconazonium sulfate
dacarbazine and isavuconazonium sulfate both decrease immunosuppressive effects; risk of infection. Use Caution/Monitor.
- lomustine
dacarbazine, lomustine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- meningococcal group B vaccine
dacarbazine decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.
- ofatumumab SC
ofatumumab SC, dacarbazine. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.
- olaparib
dacarbazine and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.
- rucaparib
rucaparib will increase the level or effect of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.
- siponimod
siponimod and dacarbazine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- sipuleucel-T
dacarbazine decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol, dacarbazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.
- streptozocin
dacarbazine, streptozocin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- teriflunomide
teriflunomide decreases levels of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- thiotepa
dacarbazine, thiotepa. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- trastuzumab
trastuzumab, dacarbazine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
- trastuzumab deruxtecan
trastuzumab deruxtecan, dacarbazine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
Minor (2)
- vitamin A
vitamin A, dacarbazine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
- vitamin E
vitamin E, dacarbazine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
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
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
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.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%)
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| dacarbazine intravenous - | 200 mg vial |  | |
| dacarbazine intravenous - | 200 mg vial |  | |
| dacarbazine intravenous - | 200 mg vial |  | |
| dacarbazine intravenous - | 100 mg vial |  | |
| dacarbazine intravenous - | 200 mg vial |  | |
| dacarbazine intravenous - | 200 mg vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
dacarbazine intravenous
DACARBAZINE - INJECTION
(duh-KAR-buh-zeen)
COMMON BRAND NAME(S): DTIC-Dome
WARNING: This medication may often cause serious blood disorders (decreased bone marrow function leading to a low number of red blood cells, white blood cells, and platelets). These effects can cause anemia, lower your body's ability to fight an infection, and increase your risk of bleeding. Dacarbazine may also cause rare but serious liver problems. These side effects may rarely be life-threatening. Your doctor will monitor you closely while you are receiving this medication.Tell your doctor right away if you develop any of the following symptoms: nausea/vomiting that doesn't stop, unusual tiredness, pale skin, easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever, chills), dark urine, yellowing eyes/skin, stomach/abdominal pain.
USES: Dacarbazine is used to treat certain types of cancer, such as skin cancer and Hodgkin's disease. It is a cancer chemotherapy drug that is used to slow or stop cancer cell growth.
HOW TO USE: This medication is given by injection into a vein by a health care professional. It is given on a schedule as directed by your doctor. The dosage is based on your medical condition, body size, and response to treatment.
SIDE EFFECTS: See also Warning section.Nausea, vomiting, and loss of appetite commonly occur. Vomiting may last up to 12 hours. Your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating for 4 to 6 hours before treatment, or limiting activity may help lessen these effects. These symptoms usually decrease after 1 to 2 days. Diarrhea, flu-like symptoms (such as discomfort, uneasiness, body aches, headache), blurred vision, or flushing/numbness/tingling of the face may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.If this medication leaks out of the vein into the tissue under the skin, it may cause serious tissue damage. Tell your doctor right away if you experience pain, burning, redness, or swelling at the injection site.Tell your doctor right away if you have any serious side effects, including: mouth sores, confusion, seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), 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.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using dacarbazine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, blood disorders, decreased bone marrow function, current infections.Tell your health care professional that you are using dacarbazine before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).Dacarbazine can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports.This drug may rarely cause blurred vision. Do not drive, use machinery, or do any activity that requires clear vision until you are sure you can perform such activities safely.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Lab and/or medical tests (such as complete blood counts) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.
STORAGE: Not applicable. This medication is given in a clinic and will not be stored at home.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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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.
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