Care During Chemotherapy and Beyond



Trade Name(s): Vidaza®, Onureg®

Other Name(s): 5-azacitadine

Azacitadine is the generic name for the trade name drugs Vidaza or Onureg. In some cases, health care professionals may use trade name or the generic name when referring to the drug.

Drug Type: Azacitadine is a cytotoxic chemotherapy drug. This medication is classified as an antimetobolite and a demethylating agent (for more detail, see "How Azacitadine Works" below).

What Azacitadine Is Used For

  • Acute myeloid leukemia (AML)
  • Myelodysplastic syndrome (MDS)

Note: 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 Azacitadine Is Given

  • As a once daily subcutaneous (under the skin) injection or as an IV (intravenous) injection
  • As a tablet taken by mouth
  • Additional instructions for tablet formulation
    • Do not split, crush or chew tablets
    • Take a dose about the same time each day
    • If a dose is missed, take the dose as soon as possible on the same day. Resume the normal schedule the following day. Do NOT take 2 doses on the same day.
    • If a dose is vomited, do not take another dose on the same day. Resume the normal schedule the following day.

The amount of azacitadine 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 you have. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of azacitadine:

  • Most people will not experience all of the side effects listed
  • Side effects are often predictable in terms of their onset, duration and severity
  • Most side effects will improve after therapy is complete
  • There are things your treatment team can do to minimize or prevent side effects

The following side effects are common (occurring in greater than 30%) for patients taking azacitadine:

These are less common side effects (occurring in 10-29%) for patients receiving azacitadine:

Not all side effects are listed above. Side effects that are very rare - occurring in less than about 10 percent of patients - are not listed here. But 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 100.4º F (38º C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • 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
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers)

Always inform your health care provider if you experience any unusual symptoms.


  • Before starting azacitadine 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 take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking azacitadine.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. This drug must not be given to a pregnant woman or a woman who intends to become pregnant. If you become pregnant while taking azacitadine, stop taking the medication immediately and call your doctor for further instructions.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking azacitadine. Barrier methods of contraception, such as condoms are recommended.
  • Do not breast feed while taking azacitadine.

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 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.
  • 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.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • 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 While Taking Azacitadine

You will be checked regularly by your doctor while you are taking azacitadine, to monitor side effects and check your response to therapy. Periodic blood work will be obtained 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 Azacitadine Works

Cancer is a disease caused by changes, also known as mutations, in DNA that change the way cells grow and divide. Cancer cells can be destroyed using many different types of medications that work in very different ways. Examples of medications that destroy cancer cells include cytotoxic chemotherapy, targeted therapy, immunotherapy, and antibody-drug conjugates.

All cells go through different phases in the cell cycle process in order to divide and grow. The cell cycle process has certain check points to keep the cell from growing out of control. Cancer cells no longer have normal checks and balances in the cell cycle process which leads to uncontrolled cell growth and division. Chemotherapy stops the cell cycle which leads to cell death.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Azacitadine is a demethylating agent and an antimetobolite and works in two different ways to kill cancer cells. DNA methylation regulates gene expression in cells. An increase in DNA methylation can lead to decreased activity of specific genes that suppress cancer cell division and growth. Azacitadine interferes and prevents methylation of DNA, thus, preventing uncontrolled growth of cancer cells. Additionally, Azacitadine’s structure is very similar to normal substances within the cell and can accidentally get incorporated into the cell’s DNA. When this happens, the cell cannot function properly and this results in cell death. This commonly occurs with cancer cells that are trying to grow very quickly.

Note: 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. 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