TEMOZOLOMIDE
Temozolomide is an imidazotetrazine alkylating agent with antituour activity. It undergoes rapid chemical conversion in the systemic circulation at physiological pH to the active compound, monomethyl triazeno iidazole carboxamide (MTIC). The cytotoxicity of MTIC is thought to be due promarily to alkylation at the O6 Position of guanine with addtional alkylation also occurring at the N7 Position. Cytotoxic lesions that develop subsequently are through to involve aberrant repair of the methyl adduct.Patients with newly diagnosed glioblastoma multiforme concomitantly with radiotherapy and then as adjuvant treatment. Patiets with recurrent high grade glooma, such as glioblastoma multiforme or anaplastic astrocytoma, patients with advanced metastatic malignant melanoma.
Concomitant phase consists of Temozolomide adiministered orally at 75mg/m2 daily for 42 days with focal adiotherapy (60Gy administered in 30 fractions) The concomitant phase is followed by the adjuvant phase (Temozolomide for 6 cycles).
Contraindicated in the case of hypersensitivity, in pregnancy, in Lactation & in patient with severe myelosuppression.
Administration of Temozolomide with ranitidine did not result in clinically significant alterations in the extent of absorption of Temozolomide. Co-administration of dexamethasone, prochlorperazine, phenytoin, carbamazepine, ondansetron, H2-receptor antagonists or phenobarbital did not alter the clearance of Temozolomide. Co-administration with valproic acid was associated with a small but statistically significant decrease ub clearance of Temozolomide. use of Temozolomide in combination with ot
