Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Temozolomide
Drug ID BADD_D02150
Description Refractory anaplastic astrocytoma (WHO grade III) and Glioblastoma multiforme (WHO grade IV) are primary malignant brain tumours with poor prognosis and limited treatment options. Despite considerable genetic heterogeneity, these tumours often have impaired DNA repair systems, rendering them initially sensitive to alkylating agents, although they invariably develop resistance to these agents over time.[A229848, A229858, L32033] Temozolomide is an imidazotetrazine prodrug that is stable at acidic pH but undergoes spontaneous nonenzymatic hydrolysis at neutral or slightly basic pH; these properties allow for both oral and intravenous administration.[A229853, A229888, A229923, L32033] Following initial hydrolysis, further reactions liberate a highly reactive methyl diazonium cation capable of methylating various residues on adenosine and guanine bases leading to DNA lesions and eventual apoptosis.[A229853, A229923] Temozomolide as an adjunct to radiotherapy followed by maintenance dosing remains the standard of care for both Glioblastoma and refractory anaplastic astrocytoma.[L32033] Temozolomide was granted FDA approval on August 11, 1999, as an oral capsule and subsequently on February 27, 2009, as an intravenous injection. It is currently marketed under the trademark TEMODAR® by Merck.[L32033]
Indications and Usage Temozolomide is indicated in adult patients for the treatment of newly diagnosed glioblastoma concomitantly with radiotherapy and for use as maintenance treatment thereafter. It is also indicated for the treatment of refractory anaplastic astrocytoma in adult patients who have experienced disease progression on a drug regimen containing nitrosourea and procarbazine.[L32033]
Marketing Status approved; investigational
ATC Code L01AX03
DrugBank ID DB00853
KEGG ID D06067
MeSH ID D000077204
PubChem ID 5394
TTD Drug ID D0C8EU
NDC Product Code 75834-143; 29902-0009; 68554-0048; 16729-050; 16729-129; 23155-774; 47335-890; 70771-1092; 75834-142; 16571-818; 0085-1366; 23155-779; 47335-893; 47335-929; 65162-802; 67877-539; 70771-1093; 16571-816; 0085-3004; 16729-049; 47335-930; 50268-761; 64980-337; 65162-806; 68382-754; 70771-1096; 64980-335; 64980-338; 65162-801; 65162-805; 67877-540; 67877-542; 68382-755; 70771-1097; 75834-144; 46014-1450; 0085-1519; 75834-146; 58175-0411; 16571-820; 0085-1425; 0085-1430; 23155-777; 47335-891; 64980-336; 67877-538; 68382-752; 70771-1094; 75834-132; 16571-821; 16729-130; 67877-541; 68382-753; 68382-756; 75834-145; 46014-1121; 50683-0485; 53104-7697; 16729-051; 50268-762; 64980-333; 65162-804; 67877-537; 68382-751; 70771-1095; 14778-1414; 66499-0015; 0085-1417; 23155-778; 64980-334; 81955-0014; 82920-703; 16571-817; 16571-819; 16729-048; 23155-775; 23155-776; 65162-803; 50683-0185; 0085-1381; 47335-892
UNII YF1K15M17Y
Synonyms Temozolomide | 8-Carbamoyl-3-methylimidazo(5,1-d)-1,2,3,5-tetrazin-4(3H)-one | Methazolastone | Temodal | Temodar | Temozolomide Hexyl Ester | TMZA-HE | CCRG 81045 | CCRG-81045 | CCRG81045 | TMZ-Bioshuttle | TMZ Bioshuttle | NSC 362856 | NSC-362856 | NSC362856 | M&B 39831 | M&B-39831 | M&B39831
Chemical Information
Molecular Formula C6H6N6O2
CAS Registry Number 85622-93-1
SMILES CN1C(=O)N2C=NC(=C2N=N1)C(=O)N
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Hemianopia homonymous17.17.01.024; 06.02.07.0070.000280%Not Available
Intracranial tumour haemorrhage24.07.04.028; 17.08.01.052; 16.32.03.0230.000168%Not Available
Metastases to bone16.22.02.005; 15.09.03.0060.000224%Not Available
Oligodendroglioma17.20.01.008; 16.30.01.0080.000168%Not Available
Recurrent cancer16.16.01.0150.000728%Not Available
Subdural hygroma17.11.01.0180.000168%Not Available
Terminal state08.01.03.079--Not Available
Metastases to meninges17.02.10.012; 16.22.02.0030.000448%Not Available
Encephalomalacia17.11.01.0160.000280%Not Available
Growth hormone deficiency05.03.02.0040.000112%Not Available
Neuroendocrine carcinoma16.24.01.007; 05.08.01.011--Not Available
Communication disorder19.19.01.008--Not Available
Cerebral cyst17.18.05.002; 16.09.05.002--Not Available
Central nervous system necrosis24.04.06.032; 17.02.10.0200.000783%
Basal ganglia haemorrhage24.07.04.021; 17.08.01.0390.000224%Not Available
Vasogenic cerebral oedema17.07.02.0080.000246%Not Available
Pancreatic neuroendocrine tumour16.24.02.005; 07.21.09.009; 05.08.01.014--Not Available
Radiation interaction08.06.03.0060.000168%Not Available
Oncologic complication16.32.03.025--Not Available
Refractory cancer16.16.01.0160.000112%Not Available
Neuroendocrine carcinoma metastatic05.08.01.012; 16.24.01.008--Not Available
Decerebrate posture15.03.05.008; 17.02.05.0540.000168%Not Available
Noninfective encephalitis17.06.05.005--Not Available
Fine motor skill dysfunction17.01.02.020--Not Available
Tumour pseudoprogression16.32.03.0320.006156%Not Available
Intracranial mass17.11.01.0170.000168%Not Available
Acquired porokeratosis23.01.01.009; 10.03.02.0050.000246%Not Available
Astrocytoma malignant16.30.02.007; 17.20.02.0070.000560%Not Available
Cerebral mass effect17.11.01.0190.000224%Not Available
Drug effective for unapproved indication12.09.02.001; 08.06.01.0370.000817%Not Available
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