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 For the treatment of adult patients diagnosed with anaplastic astrocytoma whose disease has progressed after therapy with nitrosourea and procarbazine, as well as concomitantly with radiation therapy for treatment of newly diagnosed glioblastoma multiforme. Also used as maintenance therapy for glioblastoma multiforme.
Marketing Status Prescription; Discontinued
ATC Code L01AX03
DrugBank ID DB00853
KEGG ID D06067
MeSH ID D000077204
PubChem ID 5394
TTD Drug ID D0C8EU
NDC Product Code 75834-142; 16729-049; 50268-762; 62559-923; 59923-710; 16729-050; 50683-0185; 0085-1381; 52483-0250; 14778-1414; 16729-048; 0781-2693; 62175-243; 62175-245; 62559-924; 68382-755; 0085-1519; 47335-893; 0085-3004; 67877-540; 67108-2550; 75834-146; 29902-0009; 62559-922; 70771-1092; 0781-2695; 16729-130; 0781-2692; 70771-1093; 59923-704; 70771-1096; 75834-143; 50683-0485; 47335-930; 62175-242; 47335-890; 62175-240; 68554-0048; 70771-1097; 47335-929; 62756-254; 68382-754; 46014-1450; 65162-805; 67877-542; 47335-891; 64980-333; 0781-2694; 65162-804; 62559-925; 64980-336; 62559-921; 0085-1417; 0085-1430; 59923-713; 68382-752; 67877-537; 67877-539; 67877-541; 50268-761; 0085-1425; 58175-0411; 59923-707; 47335-892; 62175-241; 59923-711; 0781-2696; 16729-129; 68382-756; 75834-144; 65162-803; 59923-706; 59923-703; 53104-7697; 66499-0015; 75834-145; 62175-244; 16729-051; 59923-708; 59923-709; 59923-712; 68382-753; 65162-801; 75834-132; 46014-1121; 64980-335; 43744-573; 65162-802; 68382-751; 63759-7003; 0085-1366; 64980-338; 64980-337; 62559-920; 65162-806; 70771-1095; 72969-070; 59923-705; 67877-538; 64980-334; 0781-2691; 70771-1094
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
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Unevaluable event08.01.03.051--Not Available
Hypophagia19.09.01.004; 14.03.01.006; 07.01.06.0100.001865%Not Available
Blood count abnormal13.01.07.0010.000533%Not Available
Skin abrasion23.03.11.018; 12.01.06.0100.000799%Not Available
Bone marrow failure01.03.03.0050.002780%
Cytopenia01.03.03.0120.000208%Not Available
Acute interstitial pneumonitis22.01.02.0160.000139%Not Available
Treatment failure08.06.01.0170.001320%Not Available
Liver injury12.01.02.003; 09.01.07.0220.001066%Not Available
Organising pneumonia22.01.02.0080.000533%Not Available
Oral disorder07.05.01.0050.000533%Not Available
Brain injury19.07.03.007; 17.11.01.0030.000417%Not Available
Traumatic liver injury12.01.02.008; 09.01.08.010--Not Available
Hypertransaminasaemia09.01.02.0050.001332%Not Available
Oropharyngeal pain22.02.05.022; 07.05.05.004--
Neurological decompensation17.02.05.0300.000533%Not Available
Acute kidney injury20.01.03.016--
Drug-induced liver injury12.03.01.044; 09.01.07.0230.002131%Not Available
White matter lesion24.04.06.027; 17.11.01.0090.000533%Not Available
Drug reaction with eosinophilia and systemic symptoms10.01.01.021; 23.03.05.005--Not Available
Pneumocystis jirovecii pneumonia11.03.07.005; 22.07.08.0090.000764%Not Available
Medication residue present13.15.01.0320.000533%Not Available
Candida infection11.03.03.021--
Immune thrombocytopenic purpura10.04.01.008; 01.08.01.0070.001066%Not Available
Multiple organ dysfunction syndrome08.01.03.057--
Anal incontinence17.05.01.021; 07.01.06.0290.000533%
Acute pulmonary histoplasmosis22.07.08.010; 11.03.06.0020.000533%Not Available
B precursor type acute leukaemia01.10.01.004; 16.01.01.0040.000533%Not Available
Brain neoplasm malignant17.20.04.002; 16.30.04.0020.000695%Not Available
Hemianopia homonymous17.17.01.024; 06.02.07.0070.001332%Not Available
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