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Indications for use
Malignant gliomas (including glioblastoma multiforme, anaplastic astrocytoma) in case of relapse or disease progression after standard therapy; widespread metastatic malignant melanoma (as a first-line therapeutic agent)
It is individual, depending on the age and previous chemotherapy. The drug should be carefully prescribed to patients with severe liver or kidney disease, elderly patients, children and adolescents.
Restrictions on use
Age up to 3 years with multiform glioblastoma and up to 18 years with malignant melanoma (efficacy and safety of application are not determined).
Reception during pregnancy and breast-feeding
The drug is contraindicated during pregnancy (there is no clinical experience). If the reception is necessary, you should warn the patient about the possible risk to the fetus. At the time of treatment the patient should stop breastfeeding (data on the penetration of breast milk are not available).
Heavy myelodysplasia, pregnancy, lactation, hypersensitivity to dacarbazine or temozolomide; Temozolomide may cause drowsiness and fatigue and, therefore, adversely affect the ability to drive vehicles and manage complex mechanisms.
Interaction with other drugs
The simultaneous use of temozolomide with valproic acid causes mild, but statistically significant decrease in the clearance of temozolomide. The simultaneous use of temozolomide with other drugs has an oppressive effect on the bone marrow; it is possible to increase the risk of mielosupression.
The reception of the drug in conjunction with ranitidine does not lead to a clinically significant change in the degree of absorption of temozolomide. The simultaneous use with dexamethasone, prochlorperazine, phenytoin, carbamazepine, ondansetron, histamine antagonists or phenobarbital does not alter the clearance of temozolomide. Due to the fact that temozolomide is not metabolized in liver and weakly binds to proteins, its effect on the pharmacokinetics of other drugs is unlikely.