Temozolomide

CLINICAL USE

Antineoplastic agent:Glioblastoma multiforme Malignant glioma

DOSE IN NORMAL RENAL FUNCTION

75 mg/m 2 daily for 42 days with radiotherapyAdjuvant phase/monotherapy: 150– 200 mg/m2 once daily for 5 daysOr according to local policy

PHARMACOKINETICS

Molecular weight :194.2

%Protein binding :

10 to 20 :

%Excreted unchanged in urine : 5–10

Volume of distribution (L/kg) :0.3–0.5 (IV) (15–18 L/m2 oral)

half-life – normal/ESRD (hrs) :1.8/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosis

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

Do not administer with food

OTHER INFORMATION

Nadir for white cell count usually occurs 21–28 days after a dose, with recovery within 1–2 weeksRapidly and completely absorbed with 100% bioavailability and has extensive tissue distributionMajor route of elimination is renal: approximately 5–10% is excreted unchanged and the remainder excreted as metabolites.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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