Trade name: Dacogen ®

Drug Type:

Decitabine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.  Decitabine is classified as an "antimetabolite" and a "demethylation" agent. For more detail, see "How Decitabine Works" section below.

What Decitabine Is Used For:

Decitabine is used in treatment of 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 Decitabine Is Given:

• As an infusion into the vein (intravenous or IV).
• The actual dosage of Decitabine 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 Decitabine:

• You will not get all of the side effects mentioned below.
• Side effects are often predictable in terms of their onset, duration, and severity.
• Side effects are almost always reversible and will go away after therapy is complete.
• Side effects are quite manageable. There are many options to minimize or prevent them.

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

• Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding, and may increase need for blood or platelet transfusions.
• Fatigue
• Fever
• Nausea
• Cough
• Petechiae  (Tiny red dots on your skin, called petechiae [pe- TEEK- ee- ay].  Can occur with low platelet count.)
• Constipation
• Diarrhea
• Hyperglycemia - high blood glucose levels

These are less common side effects for patients receiving Decitabine:

• Headache
• Difficulty sleeping
• Swelling 
• Low albumin 
• Low magnesium 
• Chills 
• Low potassium 
• Bruising 
• Rash 
• Low sodium 
• Dizziness 
• Generalized aches and pains
• Cardiac murmur 
• Poor appetite 
• Sore throat 
• Abdominal pain 
• High bilirubin blood level
• High potassium 
• Mouth sores
• Drowsiness 
• Abnormal liver function blood tests
• Confusion 
• Anxiety 
• Itching 
• Heartburn  

This list includes common and less common side effects for those taking Decitabine. 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 100.4° F (38° 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.

Precautions:

• Before starting Decitabine 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 Decitabine.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Decitabine 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 Decitabine. 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.
• Males should avoid fathering a child while on Decitabine therapy and for 2 months after treatment. 
• Do not breast feed while taking Decitabine.

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.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 teaspoon of table salt and 1 tablespoon of baking soda mixed with 8 ounces of water.
• 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.
• Avoid sun exposure. Wear SPF 15 (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 doctor while you are taking Decitabine, 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. 

Decitabine often makes blood counts worse before they improve.

How Decitabine Works:

Decitabine 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. 

Decitabine'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.

Decitabine 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.

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.

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