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What is Temozolomide?

Temozolomide (brand names:  Temodar and Temodal and Temcad) is an oral alkylating agent used for the treatment of Grade IV astrocytoma — an aggressive brain tumor, also known as glioblastoma multiforme — as well as for treating melanoma, a form of skin cancer. Temozolomide is also indicated for relapsed Grade III anaplastic astrocytoma and not indicated for, but as of 2011 used to treat oligodendroglioma brain tumors in some countries, replacing the older (and less well tolerated) PCV (Procarbazine-Lomustine-Vincristine) regimen.Temozolomide-3D
The agent was developed by Malcolm Stevens and his team at Aston University in Birmingham,  Temozolomide is a prodrug and an imidazotetrazine derivative of the alkylating agent dacarbazine. It has been available in the US since August 1999, and in other countries since the early 2000s.
The therapeutic benefit of temozolomide depends on its ability to alkylate/methylate DNA, which most often occurs at the N-7 or O-6 positions of guanine residues. This methylation damages the DNA and triggers the death of tumor cells. However, some tumor cells are able to repair this type of DNA damage, and therefore diminish the therapeutic efficacy of temozolomide, by expressing a protein O6-alkylguanine DNA alkyltransferase (AGT) encoded in humans by the O-6-methylguanine-DNA methyltransferase (MGMT) gene. In some tumors, epigenetic silencing of the MGMT gene prevents the synthesis of this enzyme, and as a consequence such tumors are more sensitive to killing by temozolomide. Conversely, the presence of AGT protein in brain tumors predicts poor response to temozolomide and these patients receive little benefit from chemotherapy with temozolomide.

How does it work?

Temodal capsules contain the active ingredient temozolomide, which is a chemotherapy medicine used to treat brain tumours.  Temozolomide capsules are also available without a brand name, ie as the generic pharmacy – medicine.

Cancers form when some cells within the body multiply uncontrollably and abnormally. These cells spread, destroying nearby tissues.  Temozolomide works by stopping the cancer cells from multiplying. It does this by binding to and damaging the DNA (genetic material) in the cancer cells. This stops the cells from growing and multiplying.

Unfortunately,  temozolomide can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells and hair cells. The most important side effect is on the bone marrow where blood cells are made. Temozolomide can decrease the production of blood cells, leaving people susceptible to infection. Regular blood tests are therefore needed to monitor the levels of blood cells.Temozolomide_structure

In most chemotherapy regimens, doses are administered in courses with intervals between to allow normal cells to recover from the adverse effects of the anticancer medicines between doses. However, during this period, cancer cells will also recover and start to replicate again. Successful treatment depends on the administration of the next course of therapy before the cancer has regrown to its previous size and the net effect is to decrease the amount of cancer with each successive course

How you have Generic Temozolomide?

Generic Temozolomide. You take temozolomide as capsules that you swallow whole with a glass of water. Take them on an empty stomach – for example, 1 hour before or after meals. Store the capsules in a safe place away from children and return any unused capsules to your pharmacy.

You may have temozolomide alongside radiotherapy for newly diagnosed brain tumours. You have radiotherapy for 6 to 7 weeks and you take the temozolomide capsules each day during this time. It is best to take them at the same time each day. If you have temozolomide together with radiotherapy you are at higher risk of getting a type of lung infection called pneumocystis carinii pneumonia, so your doctor will prescribe medicines to help protect you against this.

After the radiotherapy, or if you have a brain tumour that has come back, you may have temozolomide as a course of cycles of treatment. You take the temozolomide capsules for 5 days every 4 weeks. You may repeat this treatment up to 6 times. You can find out about how doctors plan chemotherapy in the chemotherapy section.

It is very important that you take capsules according to the instructions your doctor or pharmacist gave you. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first. If you accidentally take more temozolomide capsules than you were told to, contact your doctor, pharmacist or nurse straight away. If you forget to take a dose of temozolomide take the missed dose as soon as possible during the same day. If more than a full day has gone by, check with your doctor. Don’t take a double dose to make up for a forgotten dose, unless your doctor tells you to do that.

Temozolomide side effects are listed below. You can use the links to find out more about each side effect. Or you can go to the cancer drug side effects section for general information. If you are taking temozolomide alongside radiotherapy you may also have side effects from the radiotherapy.