Dacarbazine
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📖 Official Clinical Monograph
DGDA Approved Prescribing GuidelinesDacarzin is indicated in the treatment of metastatic malignant melanoma. In addition, Dacarzin is also indicated for Hodgkin's disease as a second-line therapy when used in combination with other effective agents.
Malignant Melanoma
: The recommended dosage is 2 to 4.5 mg/kg/day for 10 days. Treatment may be repeated at 4 week intervals. An alternate recommended dosage is 250 mg/m
2
/day IV for 5 days. Treatment may be repeated every 3 weeks.
Hodgkin’s Disease
: The recommended dosage of Dacarbazine in the treatment of Hodgkin’s disease is 150 mg/m
2
/day for 5 days, in combination with other effective drugs. Treatment may be repeated every 4 weeks. An alternative recommended dosage is 375 mg/m
2
on day 1, in combination with other effective drugs, to be repeated every 15 days.
Dacarbazine is contraindicated in patients who have demonstrated a hypersensitivity to it in the past.
Symptoms of anorexia, nausea and vomiting are the most frequently noted of all toxic reactions. Over 90% of patients are affected with the initial few doses. The vomiting lasts 1 to 12 hours and is incompletely and unpredictably palliated with phenobarbital and/or prochlorperazine. Rarely, intractable nausea and vomiting have necessitated discontinuance of therapy with Dacarzin for Injection. Rarely, Dacarzin for Injection has caused diarrhea. Some helpful suggestions include restricting the patient’s oral intake of food for 4 to 6 hours prior to treatment. The rapid toleration of these symptoms suggests that a central nervous system mechanism may be involved, and usually these symptoms subside after the first 1 or 2 days.
Hospitalization is not always necessary but adequate laboratory study capability must be available. Extravasation of the drug subcutaneously during intravenous administration may result in tissue damage and severe pain. Local pain, burning sensation and irritation at the site of injection may be relieved by locally applied hot packs. Carcinogenicity of Dacarzin was studied in rats and mice. Proliferative endocardial lesions, including fibrosarcomas and sarcomas were induced by Dacarzin in rats. In mice, administration of Dacarzin resulted in the induction of angiosarcomas of the spleen.
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.