Dacarbazine (also known as DTIC) is an intravenously administered alkylating agent used in the therapy of Hodgkin’s disease and malignant melanoma. Dacarbazine therapy has been associated with serum enzyme elevations during therapy and occasional cases of severe and distinctive acute hepatic failure, probably caused by acute sinusoidal obstruction syndrome.
Dacarbazine is a triazene derivative with antineoplastic activity. Dacarbazine alkylates and cross-links DNA during all phases of the cell cycle, resulting in disruption of DNA function, cell cycle arrest, and apoptosis. (NCI04)
Dacarbazine appears as white to ivory microcrystals or off-white crystalline solids. (NTP, 1992). Dacarbazine (also known as DTIC) is an intravenously administered alkylating agent used in the therapy of Hodgkin’s disease and malignant melanoma. Dacarbazine therapy has been associated with serum enzyme elevations during therapy and occasional cases of severe and distinctive acute hepatic failure, probably caused by acute sinusoidal obstruction syndrome.
Mechanism of Action
The mechanism of action is not known but appears to exert cytotoxic effects via its action as an alkylating agent. Other theories include DNA synthesis inhibition by its action as a purine analog and interaction with SH groups. Dacarbazine is not celled cycle-phase specific.
Dacarbazine functions as an alkylating agent after metabolic activation in the liver. It appears to inhibit the synthesis of RNA and protein more than it inhibits the synthesis of DNA. It kills cells slowly, and there appears to be no phase of the cell cycle in which sensitivity is increased
Dacarbazine is a synthetic analog of naturally occurring purine precursor 5-amino-1H-imidazole-4-carboxamide (AIC). After intravenous administration of dacarbazine, the volume of distribution exceeds total body water content suggesting localization in some body tissue, probably the liver. Its disappearance from the plasma is biphasic with an initial half-life of 19 minutes and a terminal half-life of 5 hours. 1 In a patient with renal and hepatic dysfunctions, the half-lives were lengthened to 55 minutes and 7.2 hours. 1 The average cumulative excretion of unchanged DTIC in the urine is 40% of the injected dose in 6 hours. 1 DTIC is subject to renal tubular secretion rather than glomerular filtration. At therapeutic concentrations, dacarbazine is not appreciably bound to human plasma protein.
Indications
- For the treatment of metastatic malignant melanoma. In addition, dacarbazine is also indicated for Hodgkin’s disease as a secondary-line therapy when used in combination with other antineoplastic agents.
- Hodgkin lymphoma in patients whose disease has not gotten better with other chemotherapy.
- Melanoma that has metastasized(spread to other parts of the body).
- Dacarbazine is also being studied in the treatment of other types of cancer.
- Dacarbazine is used as an antineoplastic agent in the treatment of diseases such as malignant melanomas, Hodgkin’s disease, soft-tissue sarcomas, osteogenic sarcomas, and neuroblastomas.
- Advanced Pancreatic Neuroendocrine Tumors (pNET)
- Lymphoma, Hodgkins
- Metastatic Melanoma
- Pheochromocytomas
- Advanced Medullary thyroid cancer
- Advanced Soft Tissue Sarcoma (STS)
Use in Cancer
Dacarbazine is approved to be used alone or with other drugs to treat:
- Hodgkin lymphoma in patients whose disease has not gotten better with other chemotherapy.
- Melanoma that has metastasized (spread to other parts of the body).
Dacarbazine is also being studied in the treatment of other types of cancer.
Contraindications
Dacarbazine for Injection is contraindicated in patients who have demonstrated hypersensitivity to it in the past.
- decreased function of bone marrow
- anemia
- decreased blood platelets
- low levels of white blood cells
- a blood clot in a vein of the liver
- liver tissue death
- liver problems
- decreased kidney function
- a patient who is producing milk and breastfeeding
Dosage
Strengths: 100 mg; 200 mg; 500 mg
Malignant Melanoma
- 2 to 4.5 mg/kg IV once a day for 10 days; repeat every 4 weeks
- 250 mg/m2 IV once a day for 5 days; repeat every 3 weeks
Hodgkin’s Disease
- 150 mg/m2 IV once a day for 5 days in combination therapy; repeat every 4 weeks
- 375 mg/m2 IV on Day 1 in combination therapy; repeat every 15 days
Side effects
The Most Common
- nausea, vomiting,
- bone marrow suppression,
- leukopenia,
- thrombocytopenia,
- hepatotoxicity,
- hepatic vein thrombosis and hepatocellular necrosis.
- hemopoietic depression,
- anemia, anaphylaxis,
- anorexia, diarrhea,
- facial paresthesias, death, and rarely,
- erythematous and urticarial rashes, and
- photosensitivity reactions.
- It may cause cardiovascular collapse,
- burning of the throat,
- abdominal pain, oliguria,
- anuria,
delirium, - fall of blood pressure,
- convulsions,
- muscular weakness with respiratory failure, and collapse.
- Large doses may cause gastrointestinal bleeding.
- Exposure may also result in alopecia, facial flushing, and a flu-like syndrome of fever, myalgias and malaise.
- It can cause chills, dermatological reactions, and neurotoxicity.
More Common
- nausea
- vomiting
- loss of appetite
- diarrhea
- sores in the mouth and throat
- hair loss
- the feeling of burning or tingling on the face
- flushing
- flu-like symptoms
- redness, pain, swelling or burning at the site where the injection was given
- hives
- skin rash
- itching
- difficulty breathing or swallowing
- fever, muscle aches, and general feelings of pain and tiredness
Rare
- alopecia,
- facial flushing and paraesthesia,
- orthostatic hypotension,
- ECG abnormalities,
- flu-like syndrome,
- myalgia,
- malaise,
- blurred vision,
- seizure,
- headache,
- confusion,
- lethargy,
- pain at inj site,
- tissue damage,
- cellulitis.
- photosensitivity,
- stomatitis.
Drug Interactions
| DRUG | INTERACTION |
|---|---|
| Abacavir | Dacarbazine may decrease the excretion rate of Abacavir which could result in a higher serum level. |
| Abametapir | The serum concentration of Dacarbazine can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Dacarbazine can be increased when combined with Abatacept. |
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Dacarbazine. |
| Abiraterone | The serum concentration of Dacarbazine can be increased when it is combined with Abiraterone. |
| Aceclofenac | Aceclofenac may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Acemetacin | Acemetacin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Acenocoumarol | The metabolism of Acenocoumarol can be decreased when combined with Dacarbazine. |
| Acetaminophen | The metabolism of Dacarbazine can be decreased when combined with Acetaminophen. |
| Acetazolamide | Acetazolamide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Acetylsalicylic acid | The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Dacarbazine. |
| Aclidinium | Dacarbazine may decrease the excretion rate of Aclidinium which could result in a higher serum level. |
| Acrivastine | Dacarbazine may decrease the excretion rate of Acrivastine which could result in a higher serum level. |
| Acyclovir | The metabolism of Dacarbazine can be decreased when combined with Acyclovir. |
| Adalimumab | The metabolism of Dacarbazine can be increased when combined with Adalimumab. |
| Adefovir dipivoxil | Adefovir dipivoxil may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Adenovirus type 7 vaccine live | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Dacarbazine. |
| Agomelatine | The metabolism of Agomelatine can be decreased when combined with Dacarbazine. |
| Albendazole | The metabolism of Dacarbazine can be increased when combined with Albendazole. |
| Albutrepenonacog alfa | Dacarbazine may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level. |
| Alclofenac | Alclofenac may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Dacarbazine. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Dacarbazine. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dacarbazine. |
| Allogeneic processed thymus tissue | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Dacarbazine. |
| Allopurinol | The risk or severity of adverse effects can be increased when Allopurinol is combined with Dacarbazine. |
| Almasilate | Dacarbazine may decrease the excretion rate of Almasilate which could result in a higher serum level. |
| Almotriptan | Dacarbazine may decrease the excretion rate of Almotriptan which could result in a higher serum level. |
| Alogliptin | Dacarbazine may decrease the excretion rate of Alogliptin which could result in a higher serum level. |
| Alosetron | The metabolism of Dacarbazine can be decreased when combined with Alosetron. |
| Alprazolam | Alprazolam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Alteplase | The risk or severity of bleeding can be increased when Alteplase is combined with Dacarbazine. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Dacarbazine. |
| Amantadine | Dacarbazine may decrease the excretion rate of Amantadine which could result in a higher serum level. |
| Amikacin | Dacarbazine may decrease the excretion rate of Amikacin which could result in a higher serum level. |
| Amiloride | Amiloride may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Aminophenazone | The metabolism of Aminophenazone can be decreased when combined with Dacarbazine. |
| Aminophylline | The metabolism of Aminophylline can be decreased when combined with Dacarbazine. |
| Amiodarone | The metabolism of Dacarbazine can be decreased when combined with Amiodarone. |
| Amitriptyline | The metabolism of Dacarbazine can be decreased when combined with Amitriptyline. |
| Ammonium chloride | Dacarbazine may decrease the excretion rate of Ammonium chloride which could result in a higher serum level. |
| Amoxicillin | Dacarbazine may decrease the excretion rate of Amoxicillin which could result in a higher serum level. |
| Amphetamine | Amphetamine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Amphotericin B | Amphotericin B may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ampicillin | Ampicillin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Amrinone | Dacarbazine may decrease the excretion rate of Amrinone which could result in a higher serum level. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Dacarbazine. |
| Anagrelide | The metabolism of Dacarbazine can be decreased when combined with Anagrelide. |
| Anakinra | The metabolism of Dacarbazine can be increased when combined with Anakinra. |
| Ancestim | Dacarbazine may decrease the excretion rate of Ancestim which could result in a higher serum level. |
| Ancrod | The risk or severity of bleeding can be increased when Ancrod is combined with Dacarbazine. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding can be increased when Anistreplase is combined with Dacarbazine. |
| Anthrax immune globulin human | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Dacarbazine. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Dacarbazine. |
| Antihemophilic factor (recombinant), PEGylated | Dacarbazine may decrease the excretion rate of Antihemophilic factor (recombinant), PEGylated which could result in a higher serum level. |
| Antilymphocyte immunoglobulin (horse) | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | The metabolism of Antipyrine can be decreased when combined with Dacarbazine. |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Dacarbazine. |
| Antithrombin III human | Dacarbazine may decrease the excretion rate of Antithrombin III human which could result in a higher serum level. |
| Antithymocyte immunoglobulin (rabbit) | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Dacarbazine. |
| Antrafenine | Antrafenine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Apalutamide | Dacarbazine may decrease the excretion rate of Apalutamide which could result in a higher serum level. |
| Apixaban | The risk or severity of bleeding can be increased when Apixaban is combined with Dacarbazine. |
| Apremilast | The metabolism of Dacarbazine can be increased when combined with Apremilast. |
| Ardeparin | The risk or severity of bleeding can be increased when Ardeparin is combined with Dacarbazine. |
| Arformoterol | Dacarbazine may decrease the excretion rate of Arformoterol which could result in a higher serum level. |
| Argatroban | The risk or severity of bleeding can be increased when Argatroban is combined with Dacarbazine. |
| Armodafinil | The metabolism of Dacarbazine can be increased when combined with Armodafinil. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Arsenic trioxide. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Articaine. |
| Asenapine | The metabolism of Asenapine can be decreased when combined with Dacarbazine. |
| AstraZeneca COVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Dacarbazine. |
| Atazanavir | The metabolism of Dacarbazine can be decreased when combined with Atazanavir. |
| Atomoxetine | Atomoxetine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Auranofin | Dacarbazine may decrease the excretion rate of Auranofin which could result in a higher serum level. |
| Aurothioglucose | Dacarbazine may decrease the excretion rate of Aurothioglucose which could result in a higher serum level. |
| Axitinib | The metabolism of Axitinib can be decreased when combined with Dacarbazine. |
| Azacitidine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Azacitidine. |
| Azathioprine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Azathioprine. |
| Azelaic acid | Azelaic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Azelastine | The metabolism of Azelastine can be decreased when combined with Dacarbazine. |
| Aztreonam | Aztreonam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Bacillus calmette-guerin substrain connaught live antigen | The risk or severity of infection can be increased when Bacillus Calmette-Guerin substrain Connaught live antigen is combined with Dacarbazine. |
| Bacillus Calmette-guerin substrain Russian BCG-I live antigen | The therapeutic efficacy of Bacillus Calmette-Guerin substrain Russian BCG-I live antigen can be decreased when used in combination with Dacarbazine. |
| Bacillus Calmette-Guerin substrain tice live antigen | The risk or severity of infection can be increased when Bacillus Calmette-guerin substrain tice live antigen is combined with Dacarbazine. |
| Bacitracin | Bacitracin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Baclofen | Baclofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Balsalazide | Balsalazide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Baricitinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Dacarbazine. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Dacarbazine. |
| Beclomethasone dipropionate | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Dacarbazine. |
| Belatacept | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Belatacept. |
| Belimumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Belinostat. |
| Belumosudil | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding can be increased when Bemiparin is combined with Dacarbazine. |
| Bendamustine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Bendamustine. |
| Bendroflumethiazide | Bendroflumethiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Dacarbazine. |
| Bosutinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Bosutinib. |
| Brentuximab vedotin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Brentuximab vedotin. |
| Brivaracetam | Dacarbazine may decrease the excretion rate of Brivaracetam which could result in a higher serum level. |
| Brodalumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Brodalumab. |
| Bromazepam | The metabolism of Bromazepam can be decreased when combined with Dacarbazine. |
| Bromotheophylline | Bromotheophylline may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Budesonide | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Budesonide. |
| Bumadizone | Bumadizone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Bumetanide | Bumetanide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Bupivacaine. |
| Bupropion | Dacarbazine may decrease the excretion rate of Bupropion which could result in a higher serum level. |
| Buspirone | Buspirone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Busulfan | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Busulfan. |
| Butabarbital | Butabarbital may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Cabazitaxel. |
| Caffeine | The metabolism of Dacarbazine can be decreased when combined with Caffeine. |
| Canagliflozin | Canagliflozin may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Canakinumab | The metabolism of Dacarbazine can be increased when combined with Canakinumab. |
| Cangrelor | The risk or severity of bleeding can be increased when Cangrelor is combined with Dacarbazine. |
| Cannabidiol | The metabolism of Dacarbazine can be decreased when combined with Cannabidiol. |
| Canrenoic acid | Canrenoic acid may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Capecitabine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Capecitabine. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Dacarbazine. |
| Capmatinib | The serum concentration of Dacarbazine can be increased when it is combined with Capmatinib. |
| Capreomycin | Dacarbazine may decrease the excretion rate of Capreomycin which could result in a higher serum level. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Carbamazepine is combined with Dacarbazine. |
| Carbidopa | Carbidopa may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Carboplatin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Carboplatin. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Dacarbazine. |
| Carprofen | Carprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Carvedilol | The metabolism of Carvedilol can be decreased when combined with Dacarbazine. |
| Cefaclor | Cefaclor may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefadroxil | Cefadroxil may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefalotin | Cefalotin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefamandole | Cefamandole may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefapirin | Cefapirin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefazolin | Cefazolin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefdinir | Cefdinir may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefditoren | Cefditoren may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefepime | Cefepime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefmenoxime | Cefmenoxime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefmetazole | Cefmetazole may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefonicid | Cefonicid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefoperazone | Cefoperazone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceforanide | Ceforanide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefotaxime | Cefotaxime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefotetan | Cefotetan may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefotiam | Cefotiam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefoxitin | Cefoxitin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefpiramide | Cefpiramide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefpirome | Cefpirome may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefpodoxime | Cefpodoxime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefprozil | Cefprozil may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefradine | Cefradine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftaroline fosamil | Ceftaroline fosamil may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftazidime | Ceftazidime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftibuten | Ceftibuten may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftizoxime | Ceftizoxime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftobiprole | Ceftobiprole may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ceftolozane | Dacarbazine may decrease the excretion rate of Ceftolozane which could result in a higher serum level. |
| Ceftriaxone | Ceftriaxone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cefuroxime | Cefuroxime may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Celecoxib | Celecoxib may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cephalexin | Cephalexin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Dacarbazine. |
| Cyclobenzaprine | The metabolism of Cyclobenzaprine can be decreased when combined with Dacarbazine. |
| Cyclopenthiazide | Cyclopenthiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Dacarbazine. |
| Cyclosporine | Dacarbazine may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | Cyclothiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Cyproterone acetate | The metabolism of Dacarbazine can be increased when combined with Cyproterone acetate. |
| Cytarabine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Cytarabine. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran is combined with Dacarbazine. |
| Dabigatran etexilate | Dacarbazine may decrease the excretion rate of Dabigatran etexilate which could result in a higher serum level. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Dactinomycin. |
| Dalfampridine | Dacarbazine may decrease the excretion rate of Dalfampridine which could result in a higher serum level. |
| Dalteparin | The risk or severity of bleeding can be increased when Dalteparin is combined with Dacarbazine. |
| Danaparoid | The risk or severity of bleeding can be increased when Danaparoid is combined with Dacarbazine. |
| Dapagliflozin | The metabolism of Dacarbazine can be decreased when combined with Dapagliflozin. |
| Daptomycin | Daptomycin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Dacarbazine. |
| Dasatinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Dasatinib. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Dacarbazine. |
| Decitabine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Decitabine. |
| Deferasirox | The serum concentration of Dacarbazine can be increased when it is combined with Deferasirox. |
| Deferiprone | Dacarbazine may decrease the excretion rate of Deferiprone which could result in a higher serum level. |
| Defibrotide | The risk or severity of bleeding can be increased when Defibrotide is combined with Dacarbazine. |
| Deflazacort | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Deflazacort. |
| Delafloxacin | Dacarbazine may decrease the excretion rate of Delafloxacin which could result in a higher serum level. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Dacarbazine. |
| Desipramine | Dacarbazine may decrease the excretion rate of Desipramine which could result in a higher serum level. |
| Desirudin | The risk or severity of bleeding can be increased when Desirudin is combined with Dacarbazine. |
| Desmopressin | Desmopressin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Dacarbazine. |
| Desvenlafaxine | Dacarbazine may decrease the excretion rate of Desvenlafaxine which could result in a higher serum level. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Deucravacitinib. |
| Deutetrabenazine | Dacarbazine may decrease the excretion rate of Deutetrabenazine which could result in a higher serum level. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Dexamethasone. |
| Dexfenfluramine | The metabolism of Dexfenfluramine can be decreased when combined with Dacarbazine. |
| Dexibuprofen | Dexibuprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Dexketoprofen | Dexketoprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Dexmedetomidine | The metabolism of Dacarbazine can be decreased when combined with Dexmedetomidine. |
| Dexpanthenol | Dacarbazine may decrease the excretion rate of Dexpanthenol which could result in a higher serum level. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Dacarbazine. |
| Dextran | Dacarbazine may decrease the excretion rate of Dextran which could result in a higher serum level. |
| Diacerein | The metabolism of Dacarbazine can be decreased when combined with Diacerein. |
| Diatrizoate | Diatrizoate may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Diazepam | Diazepam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Dichlorobenzyl alcohol | Dacarbazine may decrease the excretion rate of Dichlorobenzyl alcohol which could result in a higher serum level. |
| Diclofenac | The metabolism of Dacarbazine can be decreased when combined with Diclofenac. |
| Diclofenamide | Diclofenamide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Eculizumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Eculizumab. |
| Edetic acid | The risk or severity of bleeding can be increased when Edetic acid is combined with Dacarbazine. |
| Edoxaban | Dacarbazine may decrease the excretion rate of Edoxaban which could result in a higher serum level. |
| Edrophonium | Dacarbazine may decrease the excretion rate of Edrophonium which could result in a higher serum level. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Dacarbazine. |
| Efavirenz | The metabolism of Dacarbazine can be decreased when combined with Efavirenz. |
| Eltrombopag | The metabolism of Eltrombopag can be decreased when combined with Dacarbazine. |
| Emapalumab | The metabolism of Dacarbazine can be increased when combined with Emapalumab. |
| Enalaprilat | Dacarbazine may decrease the excretion rate of Enalaprilat which could result in a higher serum level. |
| Enasidenib | The metabolism of Dacarbazine can be decreased when combined with Enasidenib. |
| Enoxacin | The metabolism of Dacarbazine can be decreased when combined with Enoxacin. |
| Enoxaparin | The risk or severity of bleeding can be increased when Enoxaparin is combined with Dacarbazine. |
| Entecavir | The metabolism of Dacarbazine can be decreased when combined with Entecavir. |
| Enzalutamide | Dacarbazine may decrease the excretion rate of Enzalutamide which could result in a higher serum level. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Dacarbazine. |
| Eplerenone | Eplerenone may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Dacarbazine. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Dacarbazine. |
| Eribulin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Eribulin. |
| Erlotinib | The metabolism of Dacarbazine can be decreased when combined with Erlotinib. |
| Ertapenem | Ertapenem may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ertugliflozin | Ertugliflozin may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Dacarbazine. |
| Estazolam | Dacarbazine may decrease the excretion rate of Estazolam which could result in a higher serum level. |
| Estradiol | The metabolism of Dacarbazine can be decreased when combined with Estradiol. |
| Estradiol acetate | The metabolism of Dacarbazine can be decreased when combined with Estradiol acetate. |
| Estradiol benzoate | The metabolism of Dacarbazine can be decreased when combined with Estradiol benzoate. |
| Estradiol cypionate | The metabolism of Estradiol cypionate can be decreased when combined with Dacarbazine. |
| Estradiol dienanthate | The metabolism of Dacarbazine can be decreased when combined with Estradiol dienanthate. |
| Estradiol valerate | The metabolism of Dacarbazine can be decreased when combined with Estradiol valerate. |
| Estramustine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Estramustine. |
| Estrone sulfate | The metabolism of Dacarbazine can be decreased when combined with Estrone sulfate. |
| Eszopiclone | Eszopiclone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Etacrynic acid | Etacrynic acid may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Etafedrine | Dacarbazine may decrease the excretion rate of Etafedrine which could result in a higher serum level. |
| Etanercept | The metabolism of Dacarbazine can be increased when combined with Etanercept. |
| Ethambutol | The metabolism of Dacarbazine can be decreased when combined with Ethambutol. |
| Ethanol | The metabolism of Ethanol can be decreased when combined with Dacarbazine. |
| Ethinylestradiol | The metabolism of Ethinylestradiol can be decreased when combined with Dacarbazine. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Etidocaine. |
| Etodolac | Etodolac may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Etomidate | Etomidate may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Etonogestrel | Etonogestrel may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Dacarbazine. |
| Etoricoxib | The metabolism of Etoricoxib can be decreased when combined with Dacarbazine. |
| Eucalyptus oil | Dacarbazine may decrease the excretion rate of Eucalyptus oil which could result in a higher serum level. |
| Everolimus | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Everolimus. |
| Ezogabine | Dacarbazine may decrease the excretion rate of Ezogabine which could result in a higher serum level. |
| Famotidine | The metabolism of Dacarbazine can be decreased when combined with Famotidine. |
| Fenbufen | Fenbufen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fenfluramine | The metabolism of Dacarbazine can be decreased when combined with Fenfluramine. |
| Fenofibrate | Dacarbazine may decrease the excretion rate of Fenofibrate which could result in a higher serum level. |
| Fenofibric acid | Dacarbazine may decrease the excretion rate of Fenofibric acid which could result in a higher serum level. |
| Fenoldopam | Fenoldopam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fenoprofen | Fenoprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fentanyl | Fentanyl may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fesoterodine | Dacarbazine may decrease the excretion rate of Fesoterodine which could result in a higher serum level. |
| Fexinidazole | The metabolism of Dacarbazine can be decreased when combined with Fexinidazole. |
| Filgotinib | The serum concentration of Dacarbazine can be increased when it is combined with Filgotinib. |
| Finerenone | Finerenone may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Fingolimod | Dacarbazine may increase the immunosuppressive activities of Fingolimod. |
| Flavoxate | Dacarbazine may decrease the excretion rate of Flavoxate which could result in a higher serum level. |
| Flecainide | The metabolism of Flecainide can be decreased when combined with Dacarbazine. |
| Fluoxetine | The metabolism of Dacarbazine can be decreased when combined with Fluoxetine. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Dacarbazine. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Fluprednisolone. |
| Flurazepam | Flurazepam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Flurbiprofen | Flurbiprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Flutamide | The metabolism of Dacarbazine can be decreased when combined with Flutamide. |
| Fluticasone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Fluticasone furoate. |
| Fluticasone propionate | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Dacarbazine. |
| Fluvoxamine | The metabolism of Dacarbazine can be decreased when combined with Fluvoxamine. |
| Folic acid | Folic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fomepizole | Dacarbazine may decrease the excretion rate of Fomepizole which could result in a higher serum level. |
| Fondaparinux | Fondaparinux may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Formestane | Dacarbazine may decrease the excretion rate of Formestane which could result in a higher serum level. |
| Foscarnet | Foscarnet may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fosfomycin | Fosfomycin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fosinopril | Fosinopril may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Fosphenytoin | The metabolism of Dacarbazine can be increased when combined with Fosphenytoin. |
| Framycetin | Framycetin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Frovatriptan | The metabolism of Frovatriptan can be decreased when combined with Dacarbazine. |
| Furosemide | Furosemide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Gabapentin enacarbil | Dacarbazine may decrease the excretion rate of Gabapentin enacarbil which could result in a higher serum level. |
| Gadobenic acid | Gadobenic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Gadodiamide | Gadodiamide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Gadofosveset trisodium | Dacarbazine may decrease the excretion rate of Gadofosveset trisodium which could result in a higher serum level. |
| Gadopentetic acid | Gadopentetic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Gadoteric acid | Dacarbazine may decrease the excretion rate of Gadoteric acid which could result in a higher serum level. |
| Gadoteridol | Gadoteridol may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Gallium nitrate. |
| Ganciclovir | Dacarbazine may decrease the excretion rate of Ganciclovir which could result in a higher serum level. |
| Gatifloxacin | The metabolism of Dacarbazine can be decreased when combined with Gatifloxacin. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Dacarbazine. |
| Gemfibrozil | The metabolism of Dacarbazine can be decreased when combined with Gemfibrozil. |
| Gemifloxacin | The metabolism of Dacarbazine can be decreased when combined with Gemifloxacin. |
| Gemtuzumab ozogamicin | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Dacarbazine. |
| Gentamicin | Dacarbazine may decrease the excretion rate of Gentamicin which could result in a higher serum level. |
| Gimeracil | Dacarbazine may decrease the excretion rate of Gimeracil which could result in a higher serum level. |
| Givosiran | The serum concentration of Dacarbazine can be increased when it is combined with Givosiran. |
| Glatiramer | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Glatiramer. |
| Glipizide | Dacarbazine may decrease the excretion rate of Glipizide which could result in a higher serum level. |
| Glycerol phenylbutyrate | Dacarbazine may decrease the excretion rate of Glycerol phenylbutyrate which could result in a higher serum level. |
| Golimumab | The metabolism of Dacarbazine can be increased when combined with Golimumab. |
| Golodirsen | Dacarbazine may decrease the excretion rate of Golodirsen which could result in a higher serum level. |
| Goserelin | Goserelin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Grepafloxacin | The metabolism of Dacarbazine can be decreased when combined with Grepafloxacin. |
| Guanabenz | The metabolism of Dacarbazine can be decreased when combined with Guanabenz. |
| Guanethidine | Dacarbazine may decrease the excretion rate of Guanethidine which could result in a higher serum level. |
| Guanfacine | Dacarbazine may decrease the excretion rate of Guanfacine which could result in a higher serum level. |
| Guselkumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Guselkumab. |
| Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Dacarbazine. |
| Haloperidol | The metabolism of Dacarbazine can be decreased when combined with Haloperidol. |
| Heparin | The risk or severity of bleeding can be increased when Heparin is combined with Dacarbazine. |
| Hepatitis A Vaccine | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Dacarbazine. |
| Hepatitis B Vaccine (Recombinant) | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Dacarbazine. |
| Human adenovirus e serotype 4 strain cl-68578 antigen | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Dacarbazine. |
| Hydralazine | Dacarbazine may decrease the excretion rate of Hydralazine which could result in a higher serum level. |
| Hydrochlorothiazide | Hydrochlorothiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydrocortisone acetate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydrocortisone acetate. |
| Hydrocortisone butyrate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydrocortisone butyrate. |
| Hydrocortisone succinate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydrocortisone succinate. |
| Hydroflumethiazide | Hydroflumethiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydromorphone | Hydromorphone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Hydroxocobalamin | Hydroxocobalamin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Hydroxychloroquine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydroxychloroquine. |
| Hydroxyethyl Starch | Dacarbazine may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level. |
| Hydroxyurea | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydroxyurea. |
| Ibritumomab tiuxetan | The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Dacarbazine. |
| Ibrutinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Ibrutinib. |
| Ibuprofen | Ibuprofen may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Ibutilide | Ibutilide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Icatibant | Dacarbazine may decrease the excretion rate of Icatibant which could result in a higher serum level. |
| Icosapent | Icosapent may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Icosapent ethyl | The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Dacarbazine. |
| Idarubicin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Idarubicin. |
| Idarucizumab | Dacarbazine may decrease the excretion rate of Idarucizumab which could result in a higher serum level. |
| Idebenone | Dacarbazine may decrease the excretion rate of Idebenone which could result in a higher serum level. |
| Idelalisib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Idelalisib. |
| Ifosfamide | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Ifosfamide. |
| Iloprost | The risk or severity of bleeding can be increased when Iloprost is combined with Dacarbazine. |
| Imatinib | The risk or severity of adverse effects can be increased when Imatinib is combined with Dacarbazine. |
| Imipramine | The metabolism of Dacarbazine can be decreased when combined with Imipramine. |
| Indapamide | Indapamide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Mefenamic acid | The metabolism of Dacarbazine can be decreased when combined with Mefenamic acid. |
| Megestrol acetate | Megestrol acetate may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Melatonin | The metabolism of Melatonin can be decreased when combined with Dacarbazine. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Melphalan. |
| Memantine | Dacarbazine may decrease the excretion rate of Memantine which could result in a higher serum level. |
| Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Dacarbazine. |
| Meperidine | Meperidine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Mephenytoin | The metabolism of Dacarbazine can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Dacarbazine is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mepolizumab. |
| Meprednisone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mercaptopurine. |
| Meropenem | Meropenem may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Mesalazine | Mesalazine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Metamfetamine | Dacarbazine may decrease the excretion rate of Metamfetamine which could result in a higher serum level. |
| Metamizole | Metamizole may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Metaxalone | Metaxalone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Metformin | Metformin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Methadone | Methadone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Methazolamide | Methazolamide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Dacarbazine. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Dacarbazine. |
| Methoxsalen | The metabolism of Dacarbazine can be decreased when combined with Methoxsalen. |
| Methoxy polyethylene glycol-epoetin beta | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Dacarbazine. |
| Methyldopa | Dacarbazine may decrease the excretion rate of Methyldopa which could result in a higher serum level. |
| Methylene blue | The metabolism of Dacarbazine can be increased when combined with Methylene blue. |
| Methylnaltrexone | Dacarbazine may decrease the excretion rate of Methylnaltrexone which could result in a higher serum level. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Methylprednisolone. |
| Methyltestosterone | Dacarbazine may decrease the excretion rate of Methyltestosterone which could result in a higher serum level. |
| Meticrane | Meticrane may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoclopramide | The metabolism of Metoclopramide can be decreased when combined with Dacarbazine. |
| Metolazone | Metolazone may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoprolol | Metoprolol may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Metyrapone | Dacarbazine may decrease the excretion rate of Metyrapone which could result in a higher serum level. |
| Mexiletine | The metabolism of Dacarbazine can be decreased when combined with Mexiletine. |
| Mianserin | The metabolism of Mianserin can be decreased when combined with Dacarbazine. |
| Midazolam | Midazolam may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Migalastat | Dacarbazine may decrease the excretion rate of Migalastat which could result in a higher serum level. |
| Milnacipran | Dacarbazine may decrease the excretion rate of Milnacipran which could result in a higher serum level. |
| Milrinone | Milrinone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Mirabegron | Dacarbazine may decrease the excretion rate of Mirabegron which could result in a higher serum level. |
| Mirtazapine | The metabolism of Dacarbazine can be decreased when combined with Mirtazapine. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Dacarbazine. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mitoxantrone. |
| Moderna COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Dacarbazine. |
| Modified vaccinia ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Dacarbazine. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Monomethyl fumarate. |
| Mosunetuzumab | The metabolism of Dacarbazine can be decreased when combined with Mosunetuzumab. |
| Moxifloxacin | The metabolism of Dacarbazine can be decreased when combined with Moxifloxacin. |
| Moxisylyte | Dacarbazine may decrease the excretion rate of Moxisylyte which could result in a higher serum level. |
| Mumps virus strain B level jeryl lynn live antigen | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Dacarbazine. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Dacarbazine. |
| Muzolimine | Muzolimine may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Dacarbazine. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mycophenolic acid. |
| N-acetyltyrosine | Dacarbazine may decrease the excretion rate of N-acetyltyrosine which could result in a higher serum level. |
| Nabumetone | The metabolism of Dacarbazine can be decreased when combined with Nabumetone. |
| Nadolol | Dacarbazine may decrease the excretion rate of Nadolol which could result in a higher serum level. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Dacarbazine. |
| Nafcillin | The metabolism of Dacarbazine can be increased when combined with Nafcillin. |
| Naldemedine | Dacarbazine may decrease the excretion rate of Naldemedine which could result in a higher serum level. |
| Nalidixic acid | The metabolism of Dacarbazine can be decreased when combined with Nalidixic acid. |
| Nalmefene | Dacarbazine may decrease the excretion rate of Nalmefene which could result in a higher serum level. |
| Naloxone | Dacarbazine may decrease the excretion rate of Naloxone which could result in a higher serum level. |
| Naproxen | The metabolism of Dacarbazine can be decreased when combined with Naproxen. |
| Natalizumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Natalizumab. |
| Nateglinide | Nateglinide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nedaplatin | Dacarbazine may decrease the excretion rate of Nedaplatin which could result in a higher serum level. |
| Nedocromil | Nedocromil may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nefazodone | Dacarbazine may decrease the excretion rate of Nefazodone which could result in a higher serum level. |
| Nelarabine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Nelarabine. |
| Neomycin | Dacarbazine may decrease the excretion rate of Neomycin which could result in a higher serum level. |
| Netilmicin | Dacarbazine may decrease the excretion rate of Netilmicin which could result in a higher serum level. |
| Nevirapine | The metabolism of Dacarbazine can be decreased when combined with Nevirapine. |
| Niclosamide | The metabolism of Dacarbazine can be decreased when combined with Niclosamide. |
| Nicorandil | Dacarbazine may decrease the excretion rate of Nicorandil which could result in a higher serum level. |
| Nifedipine | The metabolism of Nifedipine can be decreased when combined with Dacarbazine. |
| Nilotinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Nilotinib. |
| Nilutamide | Nilutamide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Dacarbazine. |
| Nisoldipine | Nisoldipine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nitric Oxide | Nitric Oxide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nitrofurantoin | Nitrofurantoin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Nitroprusside | Nitroprusside may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Norfloxacin | The metabolism of Dacarbazine can be decreased when combined with Norfloxacin. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Dacarbazine. |
| Obeticholic acid | The risk or severity of adverse effects can be increased when Obeticholic acid is combined with Dacarbazine. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Obinutuzumab. |
| Zotepine | The metabolism of Zotepine can be decreased when combined with Dacarbazine. |
| Zonisamide | Zonisamide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Zolpidem | The metabolism of Dacarbazine can be decreased when combined with Zolpidem. |
| Zolmitriptan | The metabolism of Dacarbazine can be decreased when combined with Zolmitriptan. |
| Zileuton | The metabolism of Dacarbazine can be decreased when combined with Zileuton. |
| Zidovudine | The risk or severity of adverse effects can be increased when Zidovudine is combined with Dacarbazine. |
| Zanamivir | Zanamivir may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Zaleplon | Dacarbazine may decrease the excretion rate of Zaleplon which could result in a higher serum level. |
| Yellow fever vaccine | The risk or severity of infection can be increased when Yellow fever vaccine is combined with Dacarbazine. |
| Ximelagatran | The risk or severity of bleeding can be increased when Ximelagatran is combined with Dacarbazine. |
| Warfarin | The metabolism of Dacarbazine can be decreased when combined with Warfarin. |
| Voxilaprevir | The metabolism of Voxilaprevir can be decreased when combined with Dacarbazine. |
| Vortioxetine | Dacarbazine may decrease the excretion rate of Vortioxetine which could result in a higher serum level. |
| Vorinostat | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Vorinostat. |
| Vorapaxar | The risk or severity of bleeding can be increased when Vorapaxar is combined with Dacarbazine. |
| Voclosporin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Voclosporin. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Vinorelbine is combined with Dacarbazine. |
| Vindesine | The risk or severity of adverse effects can be increased when Vindesine is combined with Dacarbazine. |
| Vincristine | The risk or severity of adverse effects can be increased when Vincristine is combined with Dacarbazine. |
| Vinblastine | The risk or severity of adverse effects can be increased when Vinblastine is combined with Dacarbazine. |
| Viloxazine | The metabolism of Dacarbazine can be decreased when combined with Viloxazine. |
| Vilanterol | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Vilanterol. |
| Vibrio cholerae CVD 103-HgR strain live antigen | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Dacarbazine. |
| Verapamil | The metabolism of Dacarbazine can be decreased when combined with Verapamil. |
| Venlafaxine | Venlafaxine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Vemurafenib | The serum concentration of Dacarbazine can be increased when it is combined with Vemurafenib. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Vedolizumab. |
| Varicella zoster vaccine (recombinant) | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Dacarbazine. |
| Varicella zoster vaccine (live/attenuated) | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Dacarbazine. |
| Varenicline | Dacarbazine may decrease the excretion rate of Varenicline which could result in a higher serum level. |
| Vancomycin | Dacarbazine may decrease the excretion rate of Vancomycin which could result in a higher serum level. |
| Valproic acid | The metabolism of Dacarbazine can be decreased when combined with Valproic acid. |
| Valganciclovir | Dacarbazine may decrease the excretion rate of Valganciclovir which could result in a higher serum level. |
| Valdecoxib | Valdecoxib may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Valbenazine | Dacarbazine may decrease the excretion rate of Valbenazine which could result in a higher serum level. |
| Valaciclovir | Valaciclovir may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Vaborbactam | Dacarbazine may decrease the excretion rate of Vaborbactam which could result in a higher serum level. |
| Urokinase | The risk or severity of bleeding can be increased when Urokinase is combined with Dacarbazine. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Upadacitinib. |
| Typhoid Vi polysaccharide vaccine | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Dacarbazine. |
| Typhoid Vaccine Live | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Dacarbazine. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Dacarbazine. |
| Trovafloxacin | The metabolism of Dacarbazine can be decreased when combined with Trovafloxacin. |
| Tropisetron | Dacarbazine may decrease the excretion rate of Tropisetron which could result in a higher serum level. |
| Trimetrexate | Dacarbazine may decrease the excretion rate of Trimetrexate which could result in a higher serum level. |
| Trimethoprim | Trimethoprim may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Trimebutine | Dacarbazine may decrease the excretion rate of Trimebutine which could result in a higher serum level. |
| Trilostane | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Trilostane. |
| Trilaciclib | The metabolism of Dacarbazine can be increased when combined with Trilaciclib. |
| Triflusal | The risk or severity of bleeding can be increased when Triflusal is combined with Dacarbazine. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Dacarbazine. |
| Trifluoperazine | The metabolism of Dacarbazine can be decreased when combined with Trifluoperazine. |
| Triethylenetetramine | Dacarbazine may decrease the excretion rate of Triethylenetetramine which could result in a higher serum level. |
| Triclabendazole | The metabolism of Dacarbazine can be decreased when combined with Triclabendazole. |
| Trichlormethiazide | Trichlormethiazide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Triazolam | Dacarbazine may decrease the excretion rate of Triazolam which could result in a higher serum level. |
| Triamterene | Triamterene may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Dacarbazine. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Dacarbazine. |
| Trastuzumab emtansine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Trastuzumab emtansine. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Dacarbazine. |
| Trametinib | Dacarbazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tramadol | Tramadol may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Trabectedin | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Trabectedin. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Dacarbazine. |
| Torasemide | Torasemide may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Topotecan | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Topotecan. |
| Topiramate | Topiramate may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tolvaptan | Tolvaptan may increase the excretion rate of Dacarbazine which could result in a lower serum level and potentially a reduction in efficacy. |
| Tolterodine | Dacarbazine may decrease the excretion rate of Tolterodine which could result in a higher serum level. |
| Tolmetin | Tolmetin may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tolfenamic acid | Tolfenamic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tolcapone | Tolcapone may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tolbutamide | Dacarbazine may decrease the excretion rate of Tolbutamide which could result in a higher serum level. |
| Tolazamide | Tolazamide may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tofacitinib | Dacarbazine may increase the immunosuppressive activities of Tofacitinib. |
| Tocopherol | Dacarbazine may decrease the excretion rate of Tocopherol which could result in a higher serum level. |
| Tocilizumab | The metabolism of Dacarbazine can be increased when combined with Tocilizumab. |
| Tocainide | The metabolism of Dacarbazine can be decreased when combined with Tocainide. |
| Tobramycin | Dacarbazine may decrease the excretion rate of Tobramycin which could result in a higher serum level. |
| Tizanidine | The metabolism of Dacarbazine can be decreased when combined with Tizanidine. |
| Tixocortol | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Tixocortol. |
| Tirofiban | The risk or severity of bleeding can be increased when Tirofiban is combined with Dacarbazine. |
| Tiotropium | Dacarbazine may decrease the excretion rate of Tiotropium which could result in a higher serum level. |
| Tiopronin | Dacarbazine may decrease the excretion rate of Tiopronin which could result in a higher serum level. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Dacarbazine. |
| Tinzaparin | The risk or severity of bleeding can be increased when Tinzaparin is combined with Dacarbazine. |
| Tinidazole | Dacarbazine may decrease the excretion rate of Tinidazole which could result in a higher serum level. |
| Timolol | Timolol may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Tiludronic acid | Dacarbazine may decrease the excretion rate of Tiludronic acid which could result in a higher serum level. |
| Ticlopidine | The metabolism of Dacarbazine can be decreased when combined with Ticlopidine. |
| Tick-borne encephalitis vaccine (whole virus, inactivated) | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Dacarbazine. |
| Ticagrelor | The risk or severity of bleeding can be increased when Ticagrelor is combined with Dacarbazine. |
| Tiaprofenic acid | Tiaprofenic acid may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Thiothixene | The metabolism of Thiothixene can be decreased when combined with Dacarbazine. |
| Thiotepa | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Thiotepa. |
| Thiethylperazine | Thiethylperazine may decrease the excretion rate of Dacarbazine which could result in a higher serum level. |
| Thiabendazole | The metabolism of Dacarbazine can be decreased when combined with Thiabendazole. |
| Theophylline | The metabolism of Dacarbazine can be decreased when combined with Theophylline. |
| Thalidomide | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Thalidomide. |
Pregnancy and Lactation
Pregnancy
Pregnancy Category C:
Dacarbazine for Injection has been shown to be teratogenic in rats when given in doses 20 times the human daily dose on day 12 of gestation. Dacarbazine when administered in 10 times the human daily dose to male rats (twice weekly for 9 weeks) did not affect the male libido, although female rats mated to male rats had a higher incidence of resorptions than controls. In rabbits, dacarbazine daily dose 7 times the human daily dose given on Days 6 to 15 of gestation resulted in fetal skeletal anomalies. There are no adequate and well-controlled studies in pregnant women. Dacarbazine for Injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for tumorigenicity shown for Dacarbazine for Injection in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially alkylating agents such as dacarbazine.[1] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence; however, no data are available to determine an appropriate period to withhold breastfeeding. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
What special precautions should I follow?
Before receiving dacarbazine,
- tell your doctor and pharmacist if you are allergic to dacarbazine, any other medications, or any of the ingredients in dacarbazine injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
- tell your doctor if you are breastfeeding.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Dacarbazine may make your skin sensitive to sunlight.
WARNINGS
Hemopoietic depression is the most common toxicity with Dacarbazine for Injection and involves primarily the leukocytes and platelets, although, anemia may sometimes occur. Leukopenia and thrombocytopenia may be severe enough to cause death. Possible bone marrow depression requires careful monitoring of white blood cells, red blood cells, and platelet levels. Hemopoietic toxicity may warrant temporary suspension or cessation of therapy with Dacarbazine for Injection.
Hepatic toxicity accompanied by hepatic vein thrombosis and hepatocellular necrosis resulting in death has been reported. The incidence of such reactions has been low; approximately 0.01% of patients were treated. This toxicity has been observed mostly when Dacarbazine for Injection has been administered concomitantly with other anti-neoplastic drugs: however, it has also been reported in some patients treated with Dacarbazine for Injection alone.
Anaphylaxis can occur following the administration of Dacarbazine for Injection.
Hospitalization is not always necessary but adequate laboratory study capability must be available. Extravasation of the drug subcutaneously during intravenous administration may result in tissue damage and severe pain. Local pain, burning sensation, and irritation at the site of injection may be relieved by locally applied hot packs.
The carcinogenicity of dacarbazine was studied in rats and mice. Proliferative endocardial lesions, including fibrosarcomas and sarcomas, were induced by dacarbazine in rats. In mice, administration of dacarbazine resulted in the induction of angiosarcomas of the spleen.
References