Temozolomide
Pronunciation: te-moe-ZOE-lo-mide.
- Generic name
- temozolomide
- Brand names
- Temcad, Temomedac, Temozest, Temodar, Temodal, Temonat
- Drug class
- Alkylating agent (antineoplastic, chemotherapy)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What temozolomide is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how temozolomide works
Temozolomide is an oral alkylating agent that undergoes spontaneous hydrolysis at physiological pH to form the active compound, MTIC (monomethyl triazeno imidazole carboxamide). MTIC methylates DNA at the O6 and N7 positions of guanine, leading to DNA strand breaks and apoptosis in rapidly dividing tumor cells. (1)
What temozolomide is used for
Glioblastoma multiforme (GBM)
Glioblastoma multiforme (GBM) (1)
Anaplastic astrocytoma
Anaplastic astrocytoma (1)
Other anaplastic gliomas
Other anaplastic gliomas (1)
Refractory anaplastic astrocytoma
Refractory anaplastic astrocytoma (1)
Before taking temozolomide
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to temozolomide, dacarbazine, or any excipients. (Contraindication) (1)
- Not recommended during pregnancy or breastfeeding. (Contraindication) (1)
Tell your clinician about
(1)How to take temozolomide
- General Instructions: Take temozolomide exactly as prescribed by your doctor. Swallow capsules whole with a full glass of water, at the same time each day. Do not open or crush the capsules.. Adult Dosing: Typical dosing for newly diagnosed glioblastoma: 75 mg/m² daily during radiotherapy (42 days), followed by 150–200 mg/m² once daily for 5 days in each 28-day cycle for up to 6 cycles. Dose may be adjusted based on tolerance and blood counts.. Pediatric Dosing: Dosing in children is individualized based on body surface area and clinical response. Consult a pediatric oncologist for specific recommendations.. Administration: Take on an empty stomach or at least 1 hour before a meal to reduce nausea. If vomiting occurs after a dose, do not take an extra dose; wait until the next scheduled dose.. When To Seek Review: Do not stop taking temozolomide without consulting your doctor. Treatment may be stopped if there are severe side effects or if blood counts drop too low.. Storage: Store at room temperature (20–25°C/68–77°F), away from moisture and light. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
If you miss a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, contact your prescriber or pharmacist for guidance on the missed dose and resume your regular schedule. Do not take two doses at once.
Overdose
In case of overdose, seek emergency medical attention immediately. Symptoms may include severe bone marrow suppression, infection, or bleeding. Supportive care and monitoring of blood counts are essential. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Fatigue
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Myelosuppression
Incidence: Reported in the clinician-authored database; frequency not established
Constipation
Incidence: Reported in the clinician-authored database; frequency not established
Alopecia
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
Temozolomide can cause severe bone marrow suppression — serious
Symptoms: Temozolomide can cause severe bone marrow suppression. Risk of serious infections is increased. May cause fetal harm; avoid use in pregnancy. Use effective contraception during and after treatment. Monitor blood counts regularly during therapy.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with hypersensitivity to temozolomide, dacarbazine, or any excipients. Use with caution in patients with hepatic or renal impairment, history of myelosuppression, or active infection. Not recommended during pregnancy or breastfeeding.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Temozolomide may interact with other medications that affect bone marrow function, such as other chemotherapy agents or immunosuppressants. There are no major CYP-mediated drug interactions, but caution is advised with drugs that increase risk of infection or bleeding. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Temozolomide can cause fetal harm based on its mechanism of action (a DNA-alkylating agent) and animal reproduction data; the FDA label advises against use during pregnancy and recommends effective contraception during and after treatment. Discuss family planning with the oncology team before starting. (1)
Breastfeeding
The FDA label advises against breastfeeding during treatment with temozolomide and for a defined period after the last dose, because of the potential for serious adverse reactions in a breastfed child from this cytotoxic agent. Discuss timing with the oncology team. (1)
Children
Frequency: Not applicable.. Weight Based: Safety and efficacy not established in children; not recommended for pediatric use.. Max Daily Dose: Not applicable.. Max Single Dose: Not applicable.. Age Restrictions: Not recommended for pediatric use. (1)
Renal_impairment
Renal: no dosage adjustment needed for CLcr 36-130 mL/min/m^2; not studied below CLcr 36 or in dialysis patients — use with caution. Hepatic: no dosage adjustment is recommended for mild-to-moderate hepatic impairment (Child-Pugh class A and B); temozolomide has not been studied in severe hepatic impairment (Child-Pugh class C), and the FDA label advises caution in that population. (1)
Hepatic_impairment
Renal: no dosage adjustment needed for CLcr 36-130 mL/min/m^2; not studied below CLcr 36 or in dialysis patients — use with caution. Hepatic: no dosage adjustment is recommended for mild-to-moderate hepatic impairment (Child-Pugh class A and B); temozolomide has not been studied in severe hepatic impairment (Child-Pugh class C), and the FDA label advises caution in that population. (1)
Monitoring
(1)Storage
Store capsules at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F), per the FDA label. Keep out of reach of children; handle as a cytotoxic drug per institutional procedures.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Glioblastoma multiforme (GBM)
Dose summary: Initial dose of 75 mg/m²/day for 42 days, followed by a rest period of 28 days. Subsequent doses may be adjusted based on clinical response and tolerance.
Renal context: No clinically significant differences in temozolomide pharmacokinetics were observed based on creatinine clearance (CLcr) of 36 to 130 mL/min/m^2, so no dosage adjustment is recommended in that range. Temozolomide has not been studied in patients with CLcr below 36 mL/min/m^2 or end-stage renal disease on dialysis; the FDA label advises caution in severe renal impairment. (1)
Frequently asked questions
What is temozolomide used for?
Temozolomide is used to treat certain brain tumors, including glioblastoma multiforme and anaplastic astrocytoma, in adults and children.
How does temozolomide work?
Temozolomide works by damaging the DNA of cancer cells, which prevents them from growing and dividing.
What are the most common side effects?
The most common side effects are nausea, vomiting, fatigue, constipation, headache, and loss of appetite.
Can I take temozolomide during pregnancy?
No. Temozolomide can harm an unborn baby. Use effective contraception during treatment and for at least 6 months after the last dose.
What should I do if I miss a dose?
Take the missed dose as soon as you remember on the same day. If it is almost time for your next dose, contact your prescriber or pharmacist for guidance on the missed dose. do not take an extra dose doses.
How is temozolomide given?
Temozolomide is usually taken by mouth as a capsule, once daily, with or without food. It should be swallowed whole with water.
Are there any foods or medicines I should avoid?
Avoid live vaccines and contact with people who have infections. Always inform your doctor about all medicines and supplements you are taking.
What happens if I take too much Temozolomide?
Taking too much Temozolomide can lead to severe side effects, including profound myelosuppression, which may manifest as infections, bleeding, or anemia. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat. Prompt medical evaluation is essential for appropriate management.
Can I drink alcohol while taking Temozolomide?
It is generally advisable to avoid or limit alcohol consumption while taking Temozolomide. As an alkylating agent, Temozolomide can cause side effects like nausea, vomiting, and fatigue, which may be exacerbated by alcohol. Additionally, alcohol can potentially increase the risk of liver toxicity, a concern with many chemotherapy drugs. Consult your healthcare provider for personalized advice.
Is Temozolomide safe during pregnancy?
Temozolomide is generally not recommended during pregnancy due to potential risks to the fetus. It falls under a pregnancy category that advises against its use unless the potential benefits outweigh the risks. Women of childbearing potential should use effective contraception during treatment and for a period afterward. Always consult your healthcare provider to discuss the risks and benefits if you are pregnant or planning to become pregnant.
What is the mechanism of action of temozolomide?
Temozolomide is an oral alkylating agent that undergoes spontaneous hydrolysis at physiological pH to form the active compound, MTIC (monomethyl triazeno imidazole carboxamide). MTIC methylates DNA at the O6 and N7 positions of guanine, leading to DNA strand breaks and apoptosis in rapidly dividing tumor cells. (1)
What is the generic name of Temozolomide?
The generic name is temozolomide. It is sold under brand names including Temcad, Temomedac, Temozest, Temodar, Temodal, Temonat.
What class of drug is temozolomide?
Temozolomide is classed as: Alkylating agent (antineoplastic, chemotherapy).
References
- Temozolomide — Prescribing InformationMedGuideGlobal · United States · accessed 2026-08-03 · source 1
- Temozolomide FDA-approved prescribing informationU.S. National Library of Medicine · United States · accessed 2026-08-07 · source 2
- Temozolomide — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- Temozolomide — FDA approval record (Drugs@FDA ANDA207658)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- temozolomide — RxNorm normalized drug concept (RXCUI 37776)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient temozolomide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- TEMODAR250 mg, 140 mg, 5 mg, 100 mg, 20 mg, 2.5 mg/mL, 180 mg · merck sharp & dohme llc
Canada
- ACH-TEMOZOLOMIDE
- TEMODAL