Other Brands/Names

This medicine is marketed under the brand name Dacogen.

How It Works

Decitabine acts by blocking DNA methylation (the addition of methyl groups) within the genetic material of cancer cells. Methylation can support proper DNA formation and allow cancer cells to keep growing. When this process is inhibited, the cancer cell’s DNA cannot develop normally. If these cells fail to grow and divide correctly, they can die.

Indications

This medicine is used to treat people with myelodysplastic syndrome (a disorder involving abnormal or damaged blood-forming cells).

Contraindication

Do not use this medicine in patients with a known allergy to it. In addition, pregnant or breastfeeding women should not take this drug.

Side Effects

Possible side effects include:

• Suppressed bone marrow activity
• Lung infections
• Urinary tract infections
• Lowered blood counts, including platelets (thrombocytes) and white blood cells (neutrophils)
• Headache
• Nosebleeds
• Nausea and vomiting
• Diarrhea
• Fever
• Mouth inflammation or ulcers

Serious reactions can occur, such as body-wide infection (sepsis) or life-threatening complications like septic shock.

Types

This medication is supplied as a 50 mg injection.

Dosage

Dosing depends on the treatment schedule, as follows:

3-day Schedule Treatment

• 15 mg/m² by continuous infusion over 3 hours, then repeated every 8 hours for 3 days. After 6 weeks, the cycle may be repeated at the initial dose. The maximum daily dose is 45 mg/m².

5-day Schedule Treatment

• 20 mg/m² intravenously over one hour daily for 5 days. The cycle may be repeated four weeks after the first course. The maximum daily dose is 20 mg/m².

Safety

This drug is classified as pregnancy category N, meaning it does not fall into other defined categories. However, some studies show teratogenic effects in animal fetuses. It is also unknown whether the medicine passes into breast milk; therefore, avoid use during pregnancy and breastfeeding.

Drug Interactions

Having decitabine with cytarabine (another chemotherapy agent) in the same treatments together may enhance the effect of decitabine.

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