You will be prescribed temozolomide to take in 'cycles'. A cycle is a certain number of days where you take a dose of temozolomide, followed by a number of days without taking any doses. Your doctor will tell you how many capsules to take for each dose, and on which days to take them.
You must take the capsules when your stomach is empty, which means taking them one hour before any food, or waiting until two hours afterwards.
Your doctor will discuss with you the possibility of unwanted side-effects. You will have an increased risk of infection and bleeding, so it's important that you let your doctor know straightaway if you develop a fever or sore throat, or if you develop any unusual bleeding or bruising.
|Type of medicine||An anti-cancer medicine|
|Used for||Certain types of brain cancer|
|Also called||Temodal®; Temomedac®|
Temozolomide is used to treat specific forms of brain tumours. It is used in adults who have been newly-diagnosed as having a type of brain cancer called glioblastoma multiforme. When it is used for this type of tumour, it will be given alongside radiotherapy treatment to begin with, and then used alone. It can also be prescribed for adults and children with a type of brain cancer called malignant glioma. When it is used for this condition, it is used if the tumour has not responded to other, more standard, treatment.
Temozolomide works by interfering with how cancer cells divide and multiply. You will be prescribed it by a doctor who specialises in cancer treatment.
Before taking temozolomide
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking temozolomide, it is important that your doctor knows:
- If you are pregnant, or intend to have children in the future (this applies to men and women).
- If you are breast-feeding.
- If you have any problems with the way your liver works or how your kidneys work.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take temozolomide
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack and any other written information you are given. The manufacturer's leaflet will give you more information about temozolomide and a full list of the side-effects which you may experience from taking it.
- Temozolomide will be prescribed for you by a doctor who is experienced in treating your condition. It is usually prescribed in 'cycles', which means that a dose is taken each day for a number of days followed by several days without treatment. This cycle is then repeated a number of times. Follow the instructions you are given so that you take it exactly as you have been told by your doctor. Make sure you understand which days to take a dose.
- Temozolomide may cause you to feel or be sick. It is important that you keep taking your doses at the correct times even if you feel unwell, but do let your doctor know about it, as you can be prescribed something to help with the sickness. If you are sick after taking temozolomide, do not take a second dose on the same day.
- Do not take temozolomide at the same time as food, as your body will absorb less of the medicine. You should take the capsules at least one hour before you eat a meal, or wait until two hours after you have eaten. Swallow the capsule whole with a glass of water. Do not open or chew the capsules.
- If you forget to take a dose, take the next dose when it is due and remember to let your doctor know about the missed dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- You must try to keep your regular appointments with the doctor or hospital. This is so your progress can be checked. Temozolomide may reduce certain kinds of blood cells which are important for blood clotting and fighting infections. It can also cause damage to your liver. Because of these problems, your doctor will want to check your blood regularly while you are on temozolomide.
- You must avoid getting pregnant or fathering a child while you are on temozolomide. In addition, men must avoid fathering children for a further six months after they have finished treatment. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. Many anti-cancer treatments are associated with reduced fertility (particularly in men), so you may also want to ask your doctor for family planning advice if you intend to have children in the future.
- There are several different strengths of temozolomide capsule. Each time you get a new supply, it is a good idea to check the strength of the capsules to make sure they are what you are expecting. If you are uncertain about anything, ask your pharmacist to check with your doctor for you.
- If you are due to have an operation or dental treatment, tell the person carrying out the treatment that you are taking temozolomide.
- Do not have any immunisations (vaccinations) while you are taking this medicine and for several months afterwards, without talking to your doctor first. Temozolomide lowers your body's resistance and there is a chance that you may get an infection from some vaccines.
- If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.
- Any unwanted capsules must be disposed of in a special way - ask your local or hospital pharmacy for advice about what to do.
Can temozolomide cause problems?
Temozolomide may increase the chance of you getting an infection. You should take certain precautions to reduce the risk of this - if possible, avoid people with an infection and let your doctor know if you think you are getting a sore throat or if you have a high temperature.
Your doctor will discuss with you the possibility of unwanted side-effects of treatment. The table below contains some of the most common ones associated with temozolomide. You will find a full list in the manufacturer's information leaflet supplied with your tablets. Let your doctor know if you experience any of the following, or if you develop any other symptoms which you think may be due to this medicine:
|Very common temozolomide side-effects - these affect more than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Feeling or being sick, loss of appetite||Eat simple meals (avoid rich or spicy foods). Let your doctor know about this, as you can be prescribed an anti-sickness medicine|
|Constipation||Try to eat a well-balanced diet and drink plenty of water|
|Feeling tired||Make sure your reactions are normal before you drive or use tools or machines|
|Headache||Discuss this with your doctor who will be able to recommend a suitable painkiller|
|Skin rash and loss of hair||Speak with your doctor about this|
How to store temozolomide
- Keep all medicines out of the reach and sight of children.
- Store in the original bottle in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Temodal® Capsules; Merck Sharp & Dohme Limited, The electronic Medicines Compendium. Dated July 2013.
- British National Formulary; 66th Edition (September 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall