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Precautions and Warnings With Temozolomide

People who are undergoing chemotherapy treatment with temozolomide should be aware of associated safety precautions, including warnings for people who have a seizure disorder, kidney disease, or liver disease. People with medical issues such as these may have an increased risk for problems. Also, women who are pregnant or nursing may need to avoid this drug.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to using temozolomide (Temodar®) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • A seizure disorder
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Temozolomide Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medication include the following:
  • Temozolomide can reduce the amount of blood cells in your body, which could increase your risk for the following problems:
    • Anemia due to low red blood cells
    • Infections due to low white blood cells
    • Bleeding due to low platelets.
  • Women, as well as people who are 70 years of age or older, may be more likely to develop decreased blood cells from temozolomide.
  • Your healthcare provider will monitor your blood cell counts closely throughout treatment. You may need to delay treatment, or receive a lower temozolomide dosage, if your blood cell counts become too low. Let your healthcare provider know if you develop any signs of low blood cell counts, such as:
    • Unusual bleeding or bruising
    • Signs of infection, such as:
      • Fever
      • Chills
      • Aches and pains
    • Signs of anemia, such as:
      • Tiredness
      • Shortness of breath
      • Paleness.
  • You should know that blood problems known as myelodysplastic syndrome (a group of diseases in which the bone marrow does not make enough healthy blood cells) and a certain type of leukemia known as myeloid leukemia have been reported to occur in people who were treated with temozolomide.
  • Temozolomide may cause seizures, even in people who have never had a seizure before. Let your healthcare provider know if you have a seizure disorder.
  • People who take this medication are at risk for an infection of the lungs known as Pneumocystis carinii pneumonia (PCP). Your healthcare provider will monitor you closely for this infection, and may give you other medicines to help prevent it. Contact your healthcare provider if you develop signs of PCP, such as:
    • A dry cough
    • Shortness of breath
    • Chills
    • Fever.
  • You will need frequent blood tests while taking this medicine to monitor for potentially serious side effects, such as low blood cell counts. Make sure to keep all of your healthcare provider and laboratory appointments.
  • This medicine must be used cautiously in people with severe kidney or liver disease.
  • Temozolomide is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Temodar and Pregnancy).
  • It is not known whether temozolomide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Temodar and Breastfeeding).
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Temozolomide Drug Information

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