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Overview: Azacitidine is a medicine used to treat certain myelodysplastic syndromes and a rare type of leukemia. Common side effects include nausea and vomiting, diarrhea, and constipation. Serious side effects may include low levels of certain types of blood cells and kidney damage. Azacitidine is an injection that will be given to you by a health care provider.

Uses

What is azacitidine used for?

Azacitidine is commonly used to treat certain myelodysplastic syndromes (MDS), which are a group of conditions where your bone marrow does not make enough healthy blood cells.

Azacitidine may also be used to treat a rare type of leukemia, which is a blood cancer.

Azacitidine may also be used for other conditions as determined by your health care provider.

Azacitidine is also available in a form that is taken by mouth and used for other conditions. See Onureg (azacitidine) for more information.

How does azacitidine work (mechanism of action)?

Azacitidine is a chemotherapy drug. It may work by helping your bone marrow make healthy blood cells and by destroying, or killing, blood cells that are not normal.

How is azacitidine supplied (dosage forms)?

Brands and other names

  • Vidaza

Dosage forms and strengths

Azacitidine is available in an injectable form that is given by a health care provider.

How should I store azacitidine?

Azacitidine is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of azacitidine?

The most common side effects of azacitidine are listed below. These side effects may vary depending on the condition that is being treated. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Blood disorders (see below)
  • Fever and chills
  • Diarrhea
  • Redness or discoloration near the injection site
  • Constipation
  • Bruising or tiny red, flat spots on your skin
  • Rash
  • Weakness
  • Infection in the nose or throat, sore throat, or common cold symptoms, such as fever and a runny or stuffy nose
  • Low potassium levels
  • Stomach pain and upset stomach

There may be other side effects of azacitidine that are not listed here. Contact your health care 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 (800-332-1088). In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada or by calling 866-234-2345.

What are the serious side effects of azacitidine?

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

Severe Allergic Reactions. Azacitidine may cause allergic reactions, which can be serious. 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. Azacitidine can cause blood disorders, such as low red blood cell levels (anemia), low platelet levels (thrombocytopenia), and low neutrophil levels (neutropenia). It is important to go to all appointments for blood tests to make sure azacitidine is safe for you. 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 infections
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Kidney Damage. Kidney damage can happen when using azacitidine. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Tumor Lysis Syndrome. Azacitidine can cause a fast breakdown of cancer cells. This can lead to a condition called tumor lysis syndrome, which can be serious. It is important to drink plenty of water while receiving azacitidine and to keep all appointments for blood tests so your health care provider can see how your body is responding to the medicine. Tell your health care provider right away if you have any of the following signs of tumor lysis syndrome while using azacitidine.

  • Nausea and vomiting
  • Weakness
  • Swelling or fluid retention
  • Shortness of breath
  • Muscle cramps
  • Seizures

Warnings & Precautions

Who should not use azacitidine?

Allergies to Ingredients. People who are allergic to any of the following should not use azacitidine.

  • Azacitidine
  • Mannitol
  • Onureg
  • Vidaza
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific azacitidine products they stock.

Liver Tumors. If you have certain kinds of tumors in your liver, you should not take azacitidine. Tell your health care provider if you have ever had any liver tumors. 

What should I know about azacitidine before using it?

Azacitidine is usually given by a health care provider in a hospital or clinic. It may be given as an infusion into a vein (IV) or as an injection under the skin (subcutaneous).

It is important to attend all appointments for blood tests with your health care provider. They will use these tests to monitor your body’s response to azacitidine and make sure it is safe for you to continue using the medicine.

Azacitidine may make it hard for you to get pregnant or get your partner pregnant. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using azacitidine?

Tell your health care 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 azacitidine is right for you.

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

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Kidney problems

Pregnancy. Azacitidine may cause harm to a fetus. Your health care provider will likely make sure you are not pregnant before starting azacitidine. If you can get pregnant, you should use effective birth control while using azacitidine and for six months after your last dose. If you are able to get a partner pregnant, you should use effective birth control while using azacitidine and for three months after your last dose. Tell your health care provider right away if you are pregnant, think you might be pregnant, or plan to become pregnant.

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

Vaccines. Talk with your health care provider about any vaccines that you may need. You may not be able to receive certain vaccines right before or while using azacitidine. Tell your health care provider about any vaccines you have recently received or have scheduled.

Interactions

Does azacitidine interact with foods or drinks?

There are no known interactions between azacitidine and foods or drinks.

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

Does azacitidine interact with other medicines (drug interactions)?

There are no known interactions between azacitidine and other medicines. Always tell your health care 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 azacitidine?

If you or someone else has used too much azacitidine, 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 azacitidine?

Azacitidine is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving azacitidine as scheduled. If you miss an appointment to get your azacitidine dose, call to make another appointment as soon as possible.