Care During Chemotherapy and Beyond
Chemocare.com uses generic names in all descriptions of drugs. 5-Azacitidine is the generic name for Vidaza®. In some cases, health care
professionals may use the trade name Vidaza® when referring to the generic drug name 5-Azacitidine.
5-Azacitidine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite" and a
"demethylation" agent. (For more detail, see "How this drug works" section below.)
What 5-Azacitidine is Used For:
- Treatment of myelodysplastic syndrome (MDS)
- Chronic myelomonocytic leukemia (CMML)
- Acute myeloid leukemia (AML)
If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How 5-Azacitidine is Given:
- As a once-a-day subcutaneous (under the skin) injection or as an IV (intravenous) injection.
- The amount of azacitidine that you will receive depends on many factors, including your height and weight, your general health or other health
problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
Important things to remember about the side effects of azacitidine:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the effectiveness of the medication
The following side effects are common (occurring in greater than 30%) for patients taking azacitidine:
These side effects are less common side effects (occurring in about 10-29%) of patients receiving azacitidine:
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always
inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
- Chest pain
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Diarrhea (4-6 episodes in a 24-hour period).
- Unusual bleeding or bruising
- Black or tarry stools or blood in your stools.
- Blood in the urine.
- Bleeding gums or vaginal bleeding that is not normal.
- Extreme fatigue (unable to carry on self-care activities).
- Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
- Very bad irritation where the injection was given.
- Constipation unrelieved by stool softener.
- Swelling of the feet or ankles. Sudden weight gain.
- Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, ear or sinus pain, or painful urination.
- Change in strength on 1 side, trouble speaking, change in balance or blurred eyesight.
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.
- Before starting azacitidine treatment, make sure you tell your doctor about any other medications you are taking (including prescription,
over-the-counter, vitamins, herbal remedies, etc.).
- Do not receive any kind of immunization or vaccination without your doctor's approval while taking azacitidine.
- Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (azacitidine may be
hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
- For both men and women: Do not conceive a child (get pregnant) while taking azacitidine. Barrier methods of contraception, such as condoms, are
recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- Inform your physician of any history of liver or kidney disease you may have experienced before taking azacitidine
5-Azacitidine Self-Care Tips:
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
- You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of
infection immediately to your health care provider.
- Wash your hands often.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
- Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine.
- You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
- To lower the chance of feeling dizzy or passing out, rise slowly over a few minutes when sitting or lying down. Be careful climbing stairs.
- Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your
doctor before taking it.
- Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other
suggestions that are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking azacitidine, to monitor side effects and check your response to
therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also
be ordered by your doctor.
How 5-Azacitidine Works:
Azacitidine is a member of a new class of drugs known as DNA "demethylating" agents. Methylation of DNA is a major mechanism that regulates gene expression
in cells. When there is an increase in DNA methylation this can result in the blockage of the activity of "suppressor genes" that regulate cell division
and growth. When suppressor genes are blocked, cell division becomes unregulated, allowing or promoting cancer.
Azacitidine's anticancer effects are believed to be twofold. One way that it works is by demethylation or interfering with the methylation of DNA. By this
process of demethylation, normal function to the tumor suppressor genes is restored, thus restoring control over cell growth.
Azacitidine also belongs to the category of chemotherapy called antimetabolites. Antimetabolites are very similar to normal substances within the cell.
When the cells incorporate these substances into the cellular metabolism, they interact with a number of targets within the cell to produce a direct
cytotoxic effect that causes death of rapidly dividing cancer cells.
We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in
this website is meant to be helpful and educational, but is not a substitute for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org