dacarbazine (Rx)

Brand and Other Names:DTIC Dome
  • Print

Dosing & Uses

AdultPediatricGeriatric

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)

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

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

Next:

Interactions

Interaction Checker

and dacarbazine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (7)

              • abametapir

                abametapir will increase the level or effect of dacarbazine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.

              • 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.

              • 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.

              • 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.

              • 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.

              • tofacitinib

                dacarbazine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              Monitor Closely (33)

              • 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.

              • 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.

              Previous
              Next:

              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

              Previous
              Next:

              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

              Previous
              Next:

              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.

              Previous
              Next:

              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%)

              Previous
              Next:

              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

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              dacarbazine intravenous
              -
              200 mg vial
              dacarbazine intravenous
              -
              100 mg vial
              dacarbazine intravenous
              -
              200 mg vial
              dacarbazine intravenous
              -
              200 mg vial
              dacarbazine intravenous
              -
              200 mg vial

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Patient Education
              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: unusual tiredness, pale skin, easy bruising/bleeding, signs of infection (e.g., fever, chills, persistent sore throat), persistent nausea/vomiting, 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. 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 (e.g., discomfort, uneasiness, body aches, headache), blurred vision, or flushing/numbness/tingling of the face may also occur. If any of these effects persist or worsen, 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 of the following symptoms of a serious allergic reaction: 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.Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received polio vaccine by mouth or flu vaccine inhaled through the nose.Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g., flu, chickenpox).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 not known if this drug passes into breast milk. Due to the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.This medication can affect sperm production in men. Reliable forms of birth control should be used during treatment and for some time afterwards. Consult your doctor for more details.

              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.Some products that may interact with this drug include: drugs that may decrease bone marrow function (e.g., azathioprine, trimethoprim/sulfamethoxazole).

              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: Laboratory and/or medical tests (e.g., complete blood counts) should be performed periodically to monitor your progress or check for side effects. 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 2021. Copyright(c) 2021 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.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              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.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.