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Overview: Temozolomide is used to treat certain types of brain cancer. Common side effects include hair loss, tiredness, and nausea and vomiting. Serious side effects are rare, but include blood disorders and liver damage. Temozolomide is a capsule that you take by mouth or an infusion given in your vein (IV) by your healthcare provider.

Uses

What is temozolomide used for?

Temozolomide is commonly used to treat certain brain cancers, including glioblastoma and anaplastic astrocytoma.

Temozolomide may also be used for other conditions as determined by your healthcare provider.

How does temozolomide work (mechanism of action)?

Temozolomide is a type of medicine known as chemotherapy. It works by stopping the ability of certain cells to grow and stay alive. By killing cells, temozolomide can slow or stop cancer tumors from growing. 

How is temozolomide supplied (dosage forms)?

Brands and other names

  • Temodar

Dosage forms and strengths

  • 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg oral capsules

Temozolomide is also available in injectable forms.

How should I store temozolomide?

Oral Capsules. Temozolomide oral capsules should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Injection. Temozolomide injection is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of temozolomide?

The most common side effects of temozolomide are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Hair loss
  • Tiredness
  • Nausea and vomiting
  • Headache
  • Constipation
  • Loss of appetite
  • Muscle contractions (convulsions)
  • Blood disorders (see below)

There may be other side effects of temozolomide that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of temozolomide?

While less common, the most serious side effects of temozolomide are described below, along with what to do if they happen.

Severe Allergic Reactions. Temozolomide may cause allergic reactions, which can be serious. Stop using temozolomide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Disorders. Temozolomide can cause blood disorders, such as low neutrophils (neutropenia), low red blood cell levels (anemia), low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia). Attend all appointments for blood work so your healthcare provider can monitor your blood cell counts. Get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using temozolomide. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Lung Problems. Temozolomide can cause pneumocystis pneumonia, which is a lung problem caused by a fungus. It usually occurs when someone has a weakened immune system and a low level of lymphocytes (a specific kind of white blood cells). Keep all appointments to have your blood checked and take any medicine your healthcare provider may give you to help prevent this infection. Stop using temozolomide and get help right away if you have any of the following symptoms of pneumocystis pneumonia.

  • Fever or night sweats
  • Shortness of breath
  • Cough
  • Chest pain when breathing
  • Muscle pain
  • Weight loss

Cancer. Temozolomide can cause a new cancer to develop or cause a previously treated cancer to recur. Tell your healthcare provider about any new symptoms that you may get. Temozolomide may also increase the risk of myelodysplastic syndromes, including myeloid leukemia, which are blood disorders where your body does not make enough healthy blood cells. Keep all appointments to check your blood work during and after temozolomide treatment.

Warnings & Precautions

Who should not use temozolomide?

Allergies to Ingredients. People who are allergic to any of the following should not take temozolomide.

  • Temozolomide
  • Temodar
  • Dacarbazine
  • Dtic-Dome
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in temozolomide.

What should I know about temozolomide before using it?

Do not take temozolomide unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share temozolomide with other people, even if they have the same condition as you. It may harm them.

Keep temozolomide out of the reach of children.

Swallow temozolomide with a full glass of water. Do not open, chew, or dissolve temozolomide capsules. If you accidentally touch the powder inside of the capsule, wash the area with water right away.

Temozolomide can be taken with or without food but it should be taken the same way each day. Taking temozolomide on an empty stomach or at bedtime may help prevent nausea and vomiting.  

What should I tell my healthcare provider before using temozolomide?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if temozolomide is right for you.

In particular, make sure that you discuss any of the following.

  • Kidney problems
  • Liver problems

Pregnancy. Temozolomide may cause harm to an unborn baby. Your healthcare provider will ensure you are not pregnant before you start using temozolomide. If you can become pregnant, you should use effective contraception while using temozolomide and for six months after your last dose. If you are able to get a person pregnant, you should use effective contraception while using temozolomide and for three months after your last dose. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if temozolomide passes into breast milk. You should not breastfeed while using temozolomide and for one week after your last dose. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. 

Infertility. Temozolomide can cause infertility in people who are assigned male at birth. Talk with your healthcare provider if this is a concern for you.

Sperm Donation. Do not donate sperm while using temozolomide and for three months after your last dose.

Interactions

Does temozolomide interact with foods or drinks?

Food can affect how much temozolomide is absorbed in your body. Temozolomide can be taken with or without food, but it should be taken the same way each day.

It is unknown if drinking alcohol will affect temozolomide, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does temozolomide interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

There are no known interactions between temozolomide and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much temozolomide?

If you or someone else has used too much temozolomide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of temozolomide?

Oral Capsules. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

Injection. Temozolomide injection is usually given by a healthcare provider in a hospital. Your healthcare provider will make sure you are receiving temozolomide as scheduled. If you miss an appointment to get your temozolomide dose, call to make another appointment as soon as possible.