Dacarbazine
Synonym :
DIC
Mechanism :
Dacarbazine is an anti-cancer agent, which acts by different mechanisms i.e. inhibition of DNA synthesis by acting as a purine analog, action as an alkylating agent and interaction with SH groups.
Indication :
- Hodgkin’s disease
- Solid tumors
Contraindications :
Dacarbazine is contraindicated in patients who have demonstrated a hypersensitivity to it in the past and in patients with hepatic and/or renal insufficiency. Dose reduction and close monitoring of hepatic and bone marrow function may be required.
Dosing :
Hodgkin Lymphoma:
150 mg/m² IV every day for 5 days and to be repeated every 4 weeks OR
375 mg/m² IV on first day repeated every 15 days.
Neuroblastoma Combination Therapy (off-label):
800-900 mg/m² IV once on first day and can be repeated after every 3-4 weeks.
Adverse Effect :
Anorexia, nausea, and vomiting, influenza-like syndrome, myalgia, malaise, alopecia, facial flushing, facial paresthesia, significant liver or renal function test, erythematous and urticarial rashes.
Interaction :
Live vaccines: As dacarbazine may impair the immunological responses, administration of live vaccine may lead to the development of a generalized vaccinia.
Phenytoin, Phenobarbitone: May induce dacarbazine metabolism.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 45-60 | 80% of dose |
| 30-45 | 75% of dose |
| <30 | 70% of dose, use with caution |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Likely dialysability. Dose as in GFR<30 mL/min |
| HD | Likely dialysability. Dose as in GFR<30 mL/min |
| HDF/High flux | Likely dialysability. Dose as in GFR<30 mL/min |
| CAV/VVHD | Likely dialysability. Dose as in GFR<30 mL/min |
Hepatic Dose :
Use with caution. Adjust dose as per clinical response.