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)
Neurotoxicity17.02.10.002; 12.03.01.0110.001598%Not Available
Neutropenia01.02.03.0040.015718%Not Available
Neutrophil count13.01.06.046--Not Available
Neutrophil count decreased13.01.06.0100.002398%
Non-Hodgkin's lymphoma01.17.01.001; 16.35.01.0010.000278%Not Available
Oedema14.05.06.010; 08.01.07.0060.003197%Not Available
Oedema peripheral08.01.07.007; 02.05.04.007; 14.05.06.011--
Oesophagitis07.08.05.0010.002131%
Opportunistic infection11.01.08.007--Not Available
Oral candidiasis11.03.03.004; 07.05.07.001--Not Available
Oral pain07.05.03.0020.000799%
Orthostatic hypotension24.06.03.004; 17.05.01.0200.000533%Not Available
Otitis media11.01.05.004; 04.05.01.001--
Oxygen saturation decreased13.02.01.004--Not Available
Pain08.01.08.004--
Pain in extremity15.03.04.010--
Palpitations02.01.02.003--
Pancreatitis07.18.01.001--
Pancytopenia01.03.03.0030.011189%Not Available
Paraesthesia17.02.06.005--
Paresis17.01.04.008--Not Available
Parosmia22.04.03.007; 17.04.04.0020.000533%Not Available
Petechiae24.07.06.004; 23.06.01.003; 01.01.03.0020.000799%Not Available
Pharyngitis22.07.03.004; 11.01.13.003; 07.05.07.004--
Photophobia17.17.02.006; 06.01.01.0040.000533%
Photosensitivity reaction23.03.09.003--
Platelet count13.01.04.011--Not Available
Platelet count abnormal13.01.04.0050.000533%Not Available
Platelet count decreased13.01.04.0010.013853%
Platelet disorder01.08.03.001--Not Available
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