Book contents
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
135 - Temozolomide
Published online by Cambridge University Press: 06 October 2020
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
Summary
THERAPEUTICS
Brands
• Temodar, Temodal, Temcad, Methazolastone
Generic?
• No
Class
• Antineoplastic agent
Commonly Prescribed for
(FDA approved in bold)
• Refractory anaplastic astrocytoma
• Newly diagnosed glioblastoma multiforme (GBM) combined with radiotherapy
• Malignant prolactinoma
• Oligodendroglioma
• Primary CNS lymphoma
• Melanoma
How the Drug Works
• An alkylating agent prodrug whose clinical actions are due to metabolite methyl triazeno imidazole carboxamide (MTIC). The metabolites methylate DNA guanine bases, resulting in apoptosis of tumor cells. Treatment success is more likely in tumors with silencing of the O-6-methylguanine- DNA methyltransferase (MGMT) gene, which is important in demethylation
How Long Until It Works
• Used to prolong survival. Clinical benefits may be difficult to determine for weeks to months
If It Works
• May be continued for up to 6 cycles
If It Doesn't Work
• Discontinue treatment, consider alternative salvage chemotherapy such as bevacizumab or dexamethasone depending on clinical situation
Best Augmenting Combos for Partial Response or Treatment-Resistance
• Most patients will receive co-treatment with radiotherapy
• One small study shows potential benefit when combined with chloroquine. Another with the topoisomerase-1 inhibitor irinotecan
• O-6-Benzylguanine may be useful in those with treatment-resistant anaplastic glioma, but does not appear to be effective against GBM
Tests
• CBC before and during treatments, especially in elderly patients
• Chest radiographs in those at risk for Pneumocystis jiroveci pneumonia (PCP)
ADVERSE EFFECTS (AEs)
How the Drug Causes AEs
• Similar to other alkylating dugs, AEs are related to its effects on rapidly dividing cells
Notable AEs
• Most common: nausea/vomiting, constipation, alopecia, fatigue, anorexia, lymphopenia, thrombocytopenia
• Less common: rash, diarrhea, thrombocytopenia
Life-Threatening or Dangerous AEs
• Severe neutropenia and thrombocytopenia
• Toxic epidermal necrolysis and Stevens- Johnson syndrome have been rarely reported
• Opportunistic infections including PCP
• Rarely may cause respiratory failure
Weight Gain
• Unusual
- Type
- Chapter
- Information
- Essential NeuropharmacologyThe Prescriber's Guide, pp. 495 - 498Publisher: Cambridge University PressPrint publication year: 2015