Uses of Dacarzin: - Malignant melanoma - Hodgkin’s disease Metastatic melanoma, Hodgkin's disease, Soft tissue sarcoma Bone marrow suppression; hypersensitivity.

Cytotoxic Chemotherapy

Dacarbazine is a non-cell cycle specific antineoplastic agent. The exact mechanism of action by which it exerts cytotoxic effects is still unclear. However, three possible mechanisms have been postulated, including inhibition of DNA synthesis by acting as a purine analog, action as an alkylating agent, and interaction with sulfydryl group in the inhibition of bacterial cell growth.

How to use Dacarbazine: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: 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 Adult Dose: Intravenous Metastatic melanoma Adult: 2-4.5 mg/kg daily for 10 days, repeat at 4-wk intervals or 200-250 mg/m2 BSA daily for 5 days, repeat at 3-wk intervals or 850 mg/m2 BSA by infusion, repeat at 3-wk intervals. Hodgkin's disease Adult: 150 mg/m2 BSA daily for 5 days, repeat every 4 wk or 375 mg/m2 BSA every 15 days in combination with other agents. Soft tissue sarcoma Adult: 250 mg/m2 BSA daily for 5 days repeated every 3 wk. Usually given with doxorubicin. Child Dose: 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

Impairs immune response to vaccines; possible infection after admin of live vaccines. Effect increased by CYP1A2 inhibitors e.g. amiodarone, ciprofloxacin, fluvoxamine, ketoconazole, lomefloxacin, ofloxacin and rofecoxib. Effect decreased by CYP1A2 inducers e.g. aminoglutethimide, carbamazepine, phenobarbital and rifampicin.

Bone marrow suppression; hypersensitivity.

Common - Nausea - Vomiting - Injection site pain - Decreased white blood cell count - Loss of appetite >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 Potentially Fatal: Myelosuppression; hepatotoxicity, anaphylaxis.

Pregnancy Category C. Dacarbazine for Injection has been shown to be teratogenic in rats when given in doses 20 times the human daily dose on day 12 of gestation. Dacarbazine when administered in 10 times the human daily dose to male rats (twice weekly for 9 weeks) did not affect the male libido, although female rats mated to male rats had higher incidence of resorptions than controls. In rabbits, dacarbazine daily dose 7 times the human daily dose given on Days 6 to 15 of gestation resulted in fetal skeletal anomalies. There are no adequate and well controlled studies in pregnant women. Dacarbazine for Injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for tumorigenicity shown for Dacarbazine for Injection in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Precaution: Hepatic or renal impairment. Pregnancy, lactation. Lactation: not known if excreted in breast milk, do not nurse

Give supportive treatment and monitor blood cell counts.

Store in a refrigerator 2°C to 8°C

Cytotoxic Chemotherapy

The exact mechanism of action is still unclear but it appears to form methylcarbonium ions that attack nucleophilic groups by attaching to the 7-position of guanine on DNA. It also cross-links DNA strands leading to inhibition of DNA, RNA and protein synthesis.

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