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Dacarbazine to Treat a Type of Skin Cancer

Introduction 

Dacarbazine is used to treat melanoma (a type of skin cancer) that spreads to other parts of your body. Dacarbazine is also used with other medications to treat Hodgkin’s lymphoma (Hodgkin’s disease; a type of cancer that begins in a type of white blood cells that normally fights infection). Dacarbazine is known as purine analogues in a class of medications. It works by slowing or stopping the growth of cancer cells in your body—a triazene derivative with antineoplastic activity. Dacarbazine alkylates and cross-links DNA during all cell cycle phases, resulting in disruption of DNA function, cell cycle arrest, and apoptosis. Dacarbazine was developed by Y. Fulmer Shealy, PhD at Southern Research Institute in Birmingham, Alabama. A U.S. federal grant funded the research. FDA approved Dacarbazine in May 1975 as DTIC-Dome. Dacarbazine was approved for medical use in the United States in 1975. It is on the World Health Organization’s List of Essential Medicines.  

Dacarbazine works by methylating guanine at the O-6 and N-7 positions. Guanine is one of the four nucleotides that make up DNA. The methylated DNA strands stick together such that cell division becomes impossible. This affects cancer cells more than healthy cells because cancer cells divide faster. Unfortunately, some of the healthy cells are still damaged in this process. Dacarbazine is bioactivated in the liver by demethylation to “MTIC” and then to diazomethane, which is an alkylating agent. 

Dacarbazine injection comes as a powder to be mixed with liquid and injected intravenously (into a vein) over one minute or infused intravenously over 15 to 30 minutes by a doctor or nurse in a medical facility. When dacarbazine is used to treat melanoma, it may be injected once a day for ten days in a row every four weeks or it may be injected once a day for five days in a row every three weeks. When dacarbazine is used to treat Hodgkin’s lymphoma, may be injected once a day for five days in a row every four weeks or it may be injected once every 15 days.

 Side effects:

  • Nausea
  • Vomiting
  • Loss of appetite
  • Diarrhea
  • Sores in the mouth and throat
  • Hair loss
  • The feeling of burning or tingling on the face
  • Flushing
  • Flu-like symptoms

 If you experience any of these symptoms, call your doctor immediately:

  • Redness, pain, swelling or burning at the site where the injection was given
  • Hives
  • Skin rash
  • Itching
  • Difficulty breathing or swallowing
  • Fever, muscle aches, and a general feeling of pain and tiredness

Precautions:

  • Tell your doctor and pharmacist if you are allergic to dacarbazine, any other medications, or any of the ingredients in dacarbazine injection. Ask your pharmacist for a list of the ingredients.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
  • Tell your doctor if you are breastfeeding.
  • Plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. This may make your skin sensitive to sunlight.

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