#高警訊藥品

惡性黑色素腫瘤 Malignant melanoma; Hodgkin's disease

Antineoplastic Agent, Alkylating Agent
Dacarbazine is an alkylating agent which is converted to the active alkylating metabolite MTIC via the cytochrome P450 system. The cytotoxic effects of MTIC are manifested through alkylation (methylation) of DNA at the O6, N7 guanine positions which lead to DNA double strand breaks and apoptosis.

1. Vd: 1.49 L/kg; Protein binding: 0-5%
2. Metabolism: Hepatic; extensive
3. Excretion: (Renal) 40% unchanged
4. Elimination Half Life: (Healthy subjects) 5 hr; (Renal and hepatic dysfunction) 7.2 hr

Hypersensitivity to dacarbazine or any component of the formulation.

In general, it should be avoided during the first trimester, there should be a 3-week time period between the last chemotherapy dose and anticipated delivery, and chemotherapy should not be administered beyond week 33 of gestation.

Due to the potential for serious adverse reactions in the breastfed infant, a decision should be made to discontinue dacarbazine or to discontinue breastfeeding, taking into account the benefits of treatment to the mother.

Hemopoietic toxicity, hepatotoxicity, anaphylactic reactions, alopecia, anorexia, nausea, vomiting

Hodgkin lymphoma:
1. ABVD regimen (with doxorubicin, bleomycin, vinblastine): 375 mg/m² on days 1 and 15 every 4 weeks for 2 to 4 cycles. The number of cycles required and follow-up treatment may be determined by PET scan after 2 cycles.
2. A-AVD regimen (with brentuximab vedotin, doxorubicin, vinblastine): 375 mg/m² on days 1 and 15 every 4 weeks for up to 6 cycles. Administer primary prophylaxis with G-CSF (filgrastim) beginning with cycle 1.
Melanoma, metastatic malignant:
250 mg/m² over 30 minutes once daily on days 1 to 5 every 3 weeks for up to 12 cycles or 850 to 1,000 mg/m² once every 3 weeks.

1. CrCl ≥30 mL/min: No dosage adjustment necessary.
2. CrCl <30 mL/min: Consider reducing dose to 70% of usual dose.
3. Hemodialysis: Consider reducing dose to 70% of usual dose.

1. Mild to moderate impairment: No dosage adjustment necessary.
2. Severe impairment: Use is not recommended.

Dacarbazine, reconstituted, may be diluted in D5W (or NS) and may be stored for 72 hours at 4 ℃ or for 8 hours at 25℃ and under normal light.