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Azacitidine is also known as Onureg drug. It is commonly used to treat certain types of bone marrow cancer and blood cell disorders. Azacitidine may also be used for purposes not listed in this medication guide.1. What is Azacitidine?
Generic name or active ingredient name is: Azacitidine.
Type of drug: Anti-cancer drug; a synthetic pyrimidine Nucleoside analogue of cytidine.
Drug form and strength:
Powder for suspension for injection containing 100 mg of active ingredient Azacitidine. Oral tablets with active ingredient Azacitidine: 200 mg; 300 mg.
2. The effect of the drug Azacitidine
Azacitidine, also known as Onureg. The drug is indicated for the treatment of adults who are ineligible for hematopoietic stem cell transplantation such as:Moderate-2 and high-risk myelodysplastic syndromes according to the International Prognostic Scoring System (International Prognostic Scoring System). IPSS). Chronic myelomonocytic leukemia with 10-29% blast cells without myeloproliferative disorders. Acute myeloid leukemia with 20-30% blast cells and polyclonal dysplasia, according to the World Health Organization (WHO) classification. Acute myeloid leukemia with more than 30% blast cells according to WHO classification.
3. Usage of the drug Azacitidine
Tablet form: Azacitidine is taken orally, can be taken with or without food.
Oral suspension form:
Dilute the 100 mg vial of Azacitidine with 4 mL of sterile water for injection to make a suspension for injection. Inject subcutaneously into the thigh, abdomen, or upper arm; alternate injection sites. Do not inject the medicine into areas of skin that are tender, bruised, hot, red, or hard. If the therapeutic dose exceeds 4 mL, divide the dose evenly into 2 syringes and inject into 2 separate sites. Intravenous route:
Mix the vial containing 100mg of Azacitidine with 10ml of sterile water for injection to make a solution containing 10mg/ml. The reconstituted solution should be diluted with 50 to 100 mL of 0.9% sodium chloride solution or Ringer's lactate. Infuse the solution for 10-40 minutes. Intravenous infusion up to 1 hour after reconstitution. The vial can only be used once, do not reuse the used vial.
4. Dosage of the drug Azacitidine
4.1. For adults myelodysplastic syndrome:
First cycle: 75mg/m2 by infusion or subcutaneous injection daily for 7 days; Repeat cycle every 4 weeks. After 2 cycles, the therapeutic dose can be increased to 100 mg/m2 if no undesirable effects are observed and if there is no toxicity other than nausea and vomiting. The minimum duration of treatment is 4 to 6 cycles, although additional cycles may be required to achieve a complete or partial treatment response. Acute myeloid leukemia:
First cycle: 75mg/m2 by infusion or subcutaneous injection daily for 7 days; Repeat cycle every 4 weeks. After 2 cycles of treatment, the physician may increase the dose to 100 mg/m2 if no beneficial effect is seen and if there is no toxicity other than nausea and vomiting. The minimum duration of treatment is 4 to 6 cycles. The doctor may recommend continued treatment if the patient has a good response to treatment. 4.2. For children The safety and effectiveness of Azacitidine in children over 16 years of age have not been established.
5. Undesirable effects of the drug Azacitidine
Common unwanted side effects may include:
Fever with chills and bruising on the skin or other signs of low blood cell counts; Low blood potassium; Nausea, vomiting; Digestive disorders such as constipation or severe diarrhea; Redness or irritation at the injection site. Uncommon side effects:
Constant feeling of nausea, vomiting or severe diarrhea; redness, swelling, warmth, oozing, or other signs of a skin infection; Feeling of chest pain or wheezing; Cough with yellow or green sputum, feeling short of breath; low red blood cell count; kidney problems such as lower back pain, blood in your urine, little or no urinating, swelling in your feet or ankles; liver problems such as upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); Leg cramps; arrhythmia, a feeling of fluttering in your chest; extreme thirst, urinating several times a day, muscle weakness or limp feeling; Signs of tumor cell failure such as confusion, fatigue, numbness or tingling, muscle cramps, muscle weakness, vomiting, diarrhea, fast or slow heartbeat, seizures. Interactions of Azacitidine with other drugs:
It is not known whether the metabolism of Azacitidine is affected by known inhibitors or inducers of liver microsomal enzymes.
There have been no formal drug interaction studies with Azacitidine to date.
6. What should be avoided when using Azacitidine?
Do not give live attenuated vaccines while using Azacitidine, or you may develop a serious infection. Live attenuated vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, chickenpox (chickenpox), zoster (shingles), and nasal flu vaccines ( flu).
Azacitidine can pass into body fluids (urine, stool, vomit). For at least 48 hours after you receive a dose, avoid letting your body fluids come in contact with your hands or other surfaces.
Caregivers should wear rubber gloves while cleaning body fluids, handling dirty litter or laundry, or changing diapers. Wash hands thoroughly before and after removing gloves. When doing laundry, caregivers should sort fabrics, wash dirty clothes and linens separately from other laundry.
Avoid close contact with people who are sick or have an infection.
Inform your treating doctor immediately if you have signs of infection.
7. Some notes when using Azacitidine
Azacitidine can cause fetal toxicity. For both men and women using this medicine should use birth control to prevent pregnancy safely. Using the drug Azacitidine can cause birth defects if a parent uses the drug Azacitidine.
For women, you need to continue using birth control for at least 6 months after your last dose of Azacitidine.
For men, you need to continue using birth control for at least 3 months after your last dose.
Tell your treating doctor immediately if you find out you are pregnant while either the mother or the father is using this medicine.
Currently, there are no studies to prove whether Azacitidine passes into breast milk or if it could harm a nursing baby.
However, to be on the safe side, you should not breast-feed while using Azacitidine and for at least 1 week after your last dose of treatment.
In short, Azacitidine is a cancer treatment drug that is only used when prescribed by a doctor. Therefore, patients should consult a professional before use.
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