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)
Aplastic anaemia01.03.03.0020.000556%Not Available
Arrhythmia02.03.02.001--Not Available
Arthralgia15.01.02.001--
Aspartate aminotransferase increased13.03.01.0060.002398%
Asthenia08.01.01.0010.013321%Not Available
Asthma22.03.01.002; 10.01.03.010--Not Available
Astrocytoma17.20.01.002; 16.30.01.002--Not Available
Ataxia08.01.02.004; 17.02.02.0010.001332%
Atrial fibrillation02.03.03.002--
B-cell type acute leukaemia01.10.01.002; 16.01.01.0020.000139%Not Available
Back pain15.03.04.005--
Basal cell carcinoma23.08.02.001; 16.03.02.0010.000533%Not Available
Blastomycosis11.03.02.0010.000278%Not Available
Blindness06.02.02.001; 17.17.01.003--Not Available
Blood albumin decreased13.09.01.0010.001332%Not Available
Blood bilirubin increased13.03.01.008--
Blood glucose increased13.02.02.002--Not Available
Blood lactate dehydrogenase increased13.04.02.0020.001066%
Blood pressure decreased13.14.03.002--Not Available
Blood pressure increased13.14.03.005--Not Available
Blood sodium decreased13.11.01.0120.000533%Not Available
Blood sodium increased13.11.01.0130.000533%Not Available
Body temperature increased13.15.01.001--Not Available
Bone pain15.02.01.0010.001066%
Bradycardia02.03.02.002--Not Available
Brain herniation17.11.01.002; 12.01.10.0010.000139%Not Available
Brain stem glioma17.20.02.005; 16.30.02.0050.000799%Not Available
Brain stem infarction17.08.01.024; 24.04.06.0140.000533%Not Available
Breast pain21.05.05.003--
Bronchitis22.07.01.001; 11.01.09.001--
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