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Decitabine is a Nucleoside Metabolic Inhibitor. The mechanism of action of decitabine is as a Nucleic Acid Synthesis Inhibitor. Decitabine is a cytosine analog and an intravenously administered antineoplastic agent used in the therapy of myelodysplastic syndromes. Decitabine is associated with a low rate of transient serum enzyme elevations during therapy but has not been implicated in causing clinically apparent liver injury with jaundice.
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic neoplasms with variable underlying etiology and presentation, including neutropenia and thrombocytopenia. Further mutations leading to increased proliferation of cancerous cells can eventually lead to secondary acute myeloid leukemia, which has a poor prognosis. Among treatment options, nucleoside analogs such as decitabine and [azacitidine] integrate into cellular DNA and inhibit the action of DNA methyltransferases, leading to global hypomethylation and related downstream therapeutic benefits. Decitabine was developed by MGI Pharma/SuperGen Inc. and was approved by the FDA for the treatment of MDS on February 5, 2006. It was first marketed under the name Dacogen®. It is also available as an oral combination product together with the cytidine deaminase inhibitor [cedazuridine].
Mechanism of Action
Myelodysplastic syndromes (MDS) are a group of hematopoietic neoplasms that manifest in peripheral cytopenias and may eventually progress to secondary acute myeloid leukemia (sAML). Included in the over 45 genes commonly mutated in MDS patients are those involved in DNA methylation and histone modification, and it is well-established that alteration of the epigenetic landscape is a feature of myeloid leukemias. Decitabine is considered a prodrug, as it requires transport into cells and subsequent phosphorylation by distinct kinases to generate the active molecule 5-aza-2′-deoxycytidine-triphosphate, which is incorporated by DNA polymerase during DNA replication. Once incorporated into DNA, decitabine is recognized as a substrate by DNA methyltransferase enzymes (DNMTs), specifically DNMT1, but due to the presence of an N5 rather than C5 atom, traps the DNMT through the irreversible formation of a covalent bond. At low concentrations, this mode of action depletes DNMTs and results in global DNA hypomethylation while at high concentrations, it additionally results in double-strand breaks and cell death. The general hypothesis regarding decitabine’s therapeutic efficacy is that the global hypomethylation it induces results in the expression of previously silent tumor suppressor genes. However, there are other putative mechanisms also related to this change in DNA methylation, including indirect alteration of transcription through effects on transcription factors, indirectly altering histone modifications and chromatin structure, and activating pathways involved in DNA damage response. The overall effect of decitabine is a decrease in neoplastic cell proliferation and an increase in the expression of tumor suppressor genes.
Decitabine is a prodrug analog of the natural nucleotide 2’-deoxycytidine, which, upon being phosphorylated intracellularly, is incorporated into DNA and exerts numerous effects on gene expression. The use of decitabine is associated with neutropenia and thrombocytopenia. In addition, decitabine can cause fetal harm in pregnant women; effective contraception and avoidance of pregnancy are recommended during treatment with decitabine.
Indications
- Decitabine is indicated for the treatment of patients with myelodysplastic syndromes (MDS) including all French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia), as well as for MDS scored as belonging to the intermediate-1, intermediate-2, or high-risk group in the International Prognostic Scoring System.
- Treatment of adult patients with newly diagnosed de novo or secondary acute myeloid leukemia (AML), according to the World Health Organization (WHO) classification, who are not candidates for standard induction chemotherapy.
- For the treatment of myelodysplastic syndromes (MDS) including previously treated and untreated, de novo and secondary MDS of all French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia) and intermediate-1, intermediate-2, and high-risk International Prognostic Scoring System groups.
- It also has EU approval for acute myeloid leukemia (AML).
- Chronic Myelomonocytic Leukemia (CMML)
- Myelodysplastic Syndromes (MDS)
Use in Cancer
Decitabine is approved to treat adults with:
- Myelodysplastic syndromes (MDS), including chronic myelomonocytic leukemia (CMML).
Decitabine is also being studied in the treatment of other conditions and types of cancer. Decitabine is also available in tablet form.
Contraindications
- decreased blood platelets
- low levels of a type of white blood cell called neutrophils
- pregnancy
- a patient who is producing milk and breastfeeding
Dosage
Strengths: 50 mg
Myelodysplastic Syndrome
TREATMENT REGIMEN OPTION 1:
- 15 mg/m2 IV over 3 hours; repeat every 8 hours for 3 days; repeat this cycle every 6 weeks; patients may be premedicated with standard antiemetic therapy
If hematologic recovery (ANC 1,000/mcL or greater and platelets 50,000/mcL or greater) from a previous treatment cycle requires more than 6 weeks, then the next cycle should be delayed and dosing temporarily reduced by following this algorithm:
- Recovery requiring more than 6, but less than 8 weeks: Delay dosing for up to 2 weeks and temporarily reduce the dose to 11 mg/m2 IV every 8 hours (33 mg/m2/day, 99 mg/m2/cycle) when restarting therapy
- Recovery requiring more than 8, but less than 10 weeks: Assess patient for disease progression (by bone marrow aspirates); in the absence of progression, the dose should be delayed up to 2 more weeks and then reduced to 11 mg/m2 IV every 8 hours (33 mg/m2/day, 99 mg/m2/cycle) when restarting therapy, then maintained or increased in subsequent cycles as clinically indicated
TREATMENT REGIMEN OPTION 2:
- 20 mg/m2 IV over 1 hour; repeat daily for 5 days; repeat this cycle every 4 weeks; patients may be premedicated with standard antiemetic therapy. If myelosuppression is present, subsequent treatment cycles should be delayed until there is hematologic recovery (ANC 1,000/mcL or greater and platelets 50,000/mcL or greater)
- With either regimen, it is recommended that patients be treated for a minimum of 4 cycles; however, a complete or partial response may take longer than 4 cycles.
- Perform complete blood and platelet counts prior to each cycle and as needed to monitor response and toxicity.
- Perform liver chemistries and serum creatinine prior to initiation of therapy.
Dose Adjustments
- If any of the following nonhematologic toxicities are present, decitabine treatment should not be restarted until the toxicity is resolved: 1) serum creatinine greater than or equal to 2 mg/dL; 2) SGPT, total bilirubin greater than or equal to 2 times ULN; and 3) active or uncontrolled infection.
- Geriatric patients were generally dosed at the same level as younger adult patients. Dose adjustments for toxicity should be conducted as specified for the general population.
Administration advice:
- Once prepared, the final product should be given as a continuous IV infusion over one hour; a central venous catheter is not required.
- Premedication for the prevention of nausea and vomiting is not typically required but may be administered if necessary.
Side Effects
The Most Common
- excessive tiredness
- pale skin
- headache
- dizziness
- confusion
- fast heartbeat
- difficulty falling asleep or staying asleep
- weakness
- shortness of breath
- nausea
- constipation
- diarrhea
- vomiting
- stomach pain
- heartburn or indigestion
- painful sores in the mouth, or on the tongue or lips
- red spots on the skin
- rash
- change in skin color
- hair loss
- joint or muscle pain
- chest discomfort or chest wall pain
- swelling of the hands, feet, ankles, lower legs, or stomach
- pain, swelling, or redness at injection spot
- unusual bleeding or bruising
- hives
- itching
- difficulty breathing or swallowing
- swelling of the face
- sore throat, fever, chills, cough, or other signs of infection
More Common
- Black, tarry stools
- bladder pain
- bleeding after defecation
- bleeding gums
- blood in the urine or stools
- bloody or cloudy urine
- blue lips and fingernails
- blurred vision
- body aches or pain
- chest pain
- chills
- congestion
- cough
- coughing that sometimes produces a pink frothy sputum
- decreased urination
- difficult, burning, or painful urination
- difficult, fast, or noisy breathing
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
- drowsiness
- dry mouth or throat
- fainting
- fast or irregular heartbeat
- feeling unusually cold
- fever
- flushed, dry skin
- frequent urge to urinate
- fruit-like breath odor
- headache
- hives or welts, itching, skin rash
- hoarseness
- increased hunger
- increased sweating
- increased thirst
- increased urination
- lightheadedness
- loss of appetite
- loss of consciousness
- lower back or side pain
- mood or mental changes
- muscle pain, cramps, spasms, or twitching
- nausea
- nervousness
- numbness or tingling in the hands, feet, or lips
- pain, redness, swelling, tenderness, or warmth on the skin
- pale skin
- pinpoint red spots on the skin
- redness or pain at the catheter site
- runny nose
- seizures
- shivering
- small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope
- small red or purple spots on the skin, lips or in the mouth
- sneezing
- sore mouth, tongue, or throat
- sores, ulcers, or white spots on the lips or in the mouth
- stomach pain and bloating
- sunken eyes
- swelling of the face, hands, ankles, feet, or lower legs
- swollen, painful, or tender lymph glands in the neck, armpit, or groin
- tightness in the chest
- trembling
- trouble in swallowing
- troubled breathing with exertion
- uncomfortable swelling around the anus
- unexplained weight loss
- unusual bleeding or bruising
- unusual tiredness or weakness
- voice changes
- vomiting
- weakness or heaviness of the legs
- wrinkled skin
- yellow eyes or skin
Rare
- Collection of blood under the skin
- deep, dark purple bruise
- diarrhea
- pain or tenderness around the eyes and cheekbones
- pain, warmth, or burning in the fingers, toes, and legs
- problems with vision or hearing
- skin scrape or burn
- stuffy nose
- swelling at the injection site
- muscle stiffness
- pain in the arms or legs
- pain in joints
- stomach discomfort or upset
- swelling or inflammation of the mouth
- trouble sleeping
- unusual drowsiness, dullness, or feeling of sluggishness
- Difficulty in moving
- general feeling of discomfort or illness
- postnasal drip
- pressure in the stomach
- swollen joints
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abatacept | The risk or severity of adverse effects can be increased when Decitabine is combined with Abatacept. |
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Decitabine. |
| Acenocoumarol | The risk or severity of bleeding can be increased when Acenocoumarol is combined with Decitabine. |
| Acetylsalicylic acid | The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Decitabine. |
| Adalimumab | The risk or severity of adverse effects can be increased when Adalimumab is combined with Decitabine. |
| Adenovirus type 7 | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Decitabine. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Decitabine. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Decitabine. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Decitabine. |
| Allogeneic | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Decitabine. |
| Allopurinol | The risk or severity of adverse effects can be increased when Allopurinol is combined with Decitabine. |
| Alteplase | The risk or severity of bleeding can be increased when Alteplase is combined with Decitabine. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Decitabine. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Decitabine. |
| Anagrelide | The risk or severity of bleeding can be increased when Anagrelide is combined with Decitabine. |
| Anakinra | The risk or severity of adverse effects can be increased when Anakinra is combined with Decitabine. |
| Ancrod | The risk or severity of bleeding can be increased when Ancrod is combined with Decitabine. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding can be increased when Anistreplase is combined with Decitabine. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Decitabine. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Decitabine. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Decitabine is combined with Antilymphocyte immunoglobulin (horse). |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Decitabine. |
| Antithrombin | The risk or severity of bleeding can be increased when Antithrombin III human is combined with Decitabine. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Decitabine. |
| Apixaban | The risk or severity of bleeding can be increased when Apixaban is combined with Decitabine. |
| Apremilast | The risk or severity of adverse effects can be increased when Decitabine is combined with Apremilast. |
| Ardeparin | The risk or severity of bleeding can be increased when Ardeparin is combined with Decitabine. |
| Argatroban | The risk or severity of bleeding can be increased when Argatroban is combined with Decitabine. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Decitabine. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Articaine. |
| COVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Decitabine. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Decitabine. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Decitabine. |
| Bacillus calmette | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Decitabine. |
| calmette-guerin | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Decitabine. |
| live antigen | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Decitabine. |
| Baricitinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Decitabine. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Decitabine. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Decitabine. |
| Belatacept | The risk or severity of adverse effects can be increased when Decitabine is combined with Belatacept. |
| Belimumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Decitabine is combined with Belinostat. |
| Belumosudil | The risk or severity of adverse effects can be increased when Decitabine is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding can be increased when Bemiparin is combined with Decitabine. |
| Bendamustine | The risk or severity of adverse effects can be increased when Decitabine is combined with Bendamustine. |
| Bendroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Decitabine. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Benzocaine. |
| Benzthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Decitabine. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Benzyl alcohol. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Decitabine. |
| Betrixaban | The risk or severity of bleeding can be increased when Betrixaban is combined with Decitabine. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Decitabine. |
| Bimekizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Bimekizumab. |
| Bivalirudin | The risk or severity of bleeding can be increased when Bivalirudin is combined with Decitabine. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Decitabine. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Decitabine is combined with Blinatumomab. |
| Bordetella pertussis | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Decitabine. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Decitabine. |
| Bosutinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Bosutinib. |
| Brentuximab vedotin | The risk or severity of adverse effects can be increased when Decitabine is combined with Brentuximab vedotin. |
| Brodalumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Brodalumab. |
| Budesonide | The risk or severity of adverse effects can be increased when Budesonide is combined with Decitabine. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Bupivacaine. |
| Busulfan | The risk or severity of adverse effects can be increased when Busulfan is combined with Decitabine. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Decitabine is combined with Cabazitaxel. |
| Canakinumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Canakinumab. |
| Cangrelor | The risk or severity of bleeding can be increased when Cangrelor is combined with Decitabine. |
| Capecitabine | The risk or severity of adverse effects can be increased when Capecitabine is combined with Decitabine. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Decitabine. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Carbamazepine is combined with Decitabine. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Decitabine. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Decitabine is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Decitabine. |
| Certolizumab pegol | The risk or severity of adverse effects can be increased when Decitabine is combined with Certolizumab pegol. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Chlorambucil is combined with Decitabine. |
| Chloramphenicol | The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Decitabine. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Chloroprocaine. |
| Chlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Decitabine. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Decitabine is combined with Ciclesonide. |
| Cilostazol | The risk or severity of bleeding can be increased when Cilostazol is combined with Decitabine. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Cinchocaine. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Decitabine. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Decitabine. |
| Clobetasol propionate | The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Decitabine. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Decitabine. |
| Clopidogrel | The risk or severity of bleeding can be increased when Clopidogrel is combined with Decitabine. |
| Clostridium tetani | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Decitabine. |
| Clozapine | The risk or severity of neutropenia can be increased when Decitabine is combined with Clozapine. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Cocaine. |
| Corticotropin | The risk or severity of adverse effects can be increased when Decitabine is combined with Corticotropin. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Decitabine is combined with Cortisone acetate. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Decitabine. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Decitabine. |
| Cyclopenthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Decitabine. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Decitabine. |
| Cyclosporine | Decitabine may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Decitabine. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Decitabine. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran is combined with Decitabine. |
| Dabigatran etexilate | The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Decitabine. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Decitabine. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Decitabine. |
| Dalteparin | The risk or severity of bleeding can be increased when Dalteparin is combined with Decitabine. |
| Danaparoid | The risk or severity of bleeding can be increased when Danaparoid is combined with Decitabine. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Decitabine. |
| Dasatinib | The risk or severity of adverse effects can be increased when Dasatinib is combined with Decitabine. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Decitabine. |
| Defibrotide | The risk or severity of bleeding can be increased when Defibrotide is combined with Decitabine. |
| Deflazacort | The risk or severity of adverse effects can be increased when Decitabine is combined with Deflazacort. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Decitabine. |
| Desirudin | The risk or severity of bleeding can be increased when Desirudin is combined with Decitabine. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Decitabine. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Deucravacitinib. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Dexamethasone is combined with Decitabine. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Decitabine. |
| Dextran | The risk or severity of bleeding can be increased when Dextran is combined with Decitabine. |
| Dicoumarol | The risk or severity of bleeding can be increased when Dicoumarol is combined with Decitabine. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Decitabine is combined with Difluocortolone. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Decitabine is combined with Dimethyl fumarate. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Decitabine is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Diphenhydramine. |
| Dipyridamole | The risk or severity of bleeding can be increased when Dipyridamole is combined with Decitabine. |
| Diroximel fumarate | The risk or severity of adverse effects can be increased when Decitabine is combined with Diroximel fumarate. |
| Docetaxel | The risk or severity of adverse effects can be increased when Docetaxel is combined with Decitabine. |
| Doxorubicin | The risk or severity of adverse effects can be increased when Doxorubicin is combined with Decitabine. |
| Drotrecogin alfa | The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Decitabine. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Dyclonine. |
| Ebola Zaire vaccine | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Decitabine. |
| Eculizumab | The risk or severity of adverse effects can be increased when Eculizumab is combined with Decitabine. |
| Edetic acid | The risk or severity of bleeding can be increased when Edetic acid is combined with Decitabine. |
| Edoxaban | The risk or severity of bleeding can be increased when Edoxaban is combined with Decitabine. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Decitabine. |
| Emapalumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Emapalumab. |
| Enoxaparin | The risk or severity of bleeding can be increased when Enoxaparin is combined with Decitabine. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Decitabine. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Decitabine. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Decitabine. |
| Eribulin | The risk or severity of adverse effects can be increased when Decitabine is combined with Eribulin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Decitabine. |
| Estramustine | The risk or severity of adverse effects can be increased when Estramustine is combined with Decitabine. |
| Etanercept | The risk or severity of adverse effects can be increased when Etanercept is combined with Decitabine. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Etidocaine. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Decitabine. |
| Everolimus | The risk or severity of adverse effects can be increased when Decitabine is combined with Everolimus. |
| Famtozinameran | The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Decitabine. |
| Filgotinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Filgotinib. |
| Fingolimod | Decitabine may increase the immunosuppressive activities of Fingolimod. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Decitabine. |
| Flucytosine | The risk or severity of adverse effects can be increased when Flucytosine is combined with Decitabine. |
| Fludarabine | The risk or severity of adverse effects can be increased when Fludarabine is combined with Decitabine. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Decitabine. |
| Fluindione | The risk or severity of bleeding can be increased when Fluindione is combined with Decitabine. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Decitabine. |
| Fluocinolone acetonide | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Decitabine. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Fluocinonide is combined with Decitabine. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Decitabine is combined with Fluocortolone. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Decitabine. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Decitabine. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Decitabine. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Decitabine is combined with Fluprednisolone. |
| Fluticasone | The risk or severity of adverse effects can be increased when Decitabine is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Decitabine is combined with Fluticasone furoate. |
| Fluticasone propionate | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Decitabine. |
| Fondaparinux | The risk or severity of bleeding can be increased when Fondaparinux is combined with Decitabine. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Decitabine is combined with Gallium nitrate. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Decitabine. |
| Gemtuzumab | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Decitabine. |
| Glatiramer | The risk or severity of adverse effects can be increased when Decitabine is combined with Glatiramer. |
| Golimumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Golimumab. |
| Guselkumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Guselkumab. |
| Haemophilus | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Decitabine. |
| Heparin | The risk or severity of bleeding can be increased when Heparin is combined with Decitabine. |
| Hepatitis A | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Decitabine. |
| Hepatitis B | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Decitabine. |
| Human adenovirus | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Decitabine. |
| Hydrochlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Decitabine. |
| Hydrocortisone acetate | The risk or severity of adverse effects can be increased when Decitabine is combined with Hydrocortisone acetate. |
| Hydrocortisone butyrate | The risk or severity of adverse effects can be increased when Decitabine is combined with Hydrocortisone butyrate. |
| Hydrocortisone succinate | The risk or severity of adverse effects can be increased when Decitabine is combined with Hydrocortisone succinate. |
| Hydroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Decitabine. |
| Hydroxychloroquine | The risk or severity of adverse effects can be increased when Decitabine is combined with Hydroxychloroquine. |
| Hydroxyurea | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Decitabine. |
| Ibritumomab tiuxetan | The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Decitabine. |
| Ibrutinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Ibrutinib. |
| Icosapent ethyl | The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Decitabine. |
| Idarubicin | The risk or severity of adverse effects can be increased when Idarubicin is combined with Decitabine. |
| Idelalisib | The risk or severity of adverse effects can be increased when Decitabine is combined with Idelalisib. |
| Ifosfamide | The risk or severity of adverse effects can be increased when Ifosfamide is combined with Decitabine. |
| Iloprost | The risk or severity of bleeding can be increased when Iloprost is combined with Decitabine. |
| Imatinib | The risk or severity of adverse effects can be increased when Imatinib is combined with Decitabine. |
| Indomethacin | The risk or severity of adverse effects can be increased when Indomethacin is combined with Decitabine. |
| Inebilizumab | The risk or severity of infection can be increased when Decitabine is combined with Inebilizumab. |
| Infliximab | The risk or severity of adverse effects can be increased when Infliximab is combined with Decitabine. |
| Leflunomide | The risk or severity of adverse effects can be increased when Decitabine is combined with Leflunomide. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Decitabine. |
| Lepirudin | The risk or severity of bleeding can be increased when Lepirudin is combined with Decitabine. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Levobupivacaine. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Lidocaine. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Decitabine. |
| Lipegfilgrastim | Decitabine may increase the myelosuppressive activities of Lipegfilgrastim. |
| Lomustine | The risk or severity of adverse effects can be increased when Lomustine is combined with Decitabine. |
| Lopinavir | The serum concentration of Decitabine can be increased when it is combined with Lopinavir. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Decitabine. |
| Measles virus | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Decitabine. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Decitabine. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Decitabine. |
| Meningococcal | 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 Decitabine. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Mepolizumab. |
| Meprednisone | The risk or severity of adverse effects can be increased when Decitabine is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Decitabine. |
| Metamizole | The risk or severity of myelosuppression can be increased when Metamizole is combined with Decitabine. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Decitabine. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Decitabine. |
| Methoxy poly | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Decitabine. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Decitabine. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Decitabine. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Decitabine. |
| COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Decitabine. |
| Modified vaccinia | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Decitabine. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Decitabine is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Decitabine is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Mosunetuzumab. |
| Mumps virus strain | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Decitabine. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Decitabine. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Decitabine. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Decitabine. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Decitabine. |
| Natalizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Natalizumab. |
| Nelarabine | The risk or severity of adverse effects can be increased when Decitabine is combined with Nelarabine. |
| Nilotinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Nilotinib. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Decitabine. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Decitabine. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Obinutuzumab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Decitabine. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Ofatumumab. |
| Olaparib | The risk or severity of adverse effects can be increased when Decitabine is combined with Olaparib. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Decitabine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Oxybuprocaine. |
| Ozanimod | The risk or severity of adverse effects can be increased when Decitabine is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Paclitaxel is combined with Decitabine. |
| Palbociclib | The risk or severity of adverse effects can be increased when Decitabine is combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Decitabine. |
| Panobinostat | The risk or severity of adverse effects can be increased when Decitabine is combined with Panobinostat. |
| Parnaparin | The risk or severity of bleeding can be increased when Parnaparin is combined with Decitabine. |
| Pazopanib | The risk or severity of adverse effects can be increased when Decitabine is combined with Pazopanib. |
| Pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Decitabine. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Decitabine is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Decitabine. |
| Peginterferon alfa-2a | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Decitabine. |
| Peginterferon alfa-2b | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Decitabine. |
| Peginterferon beta-1a | The risk or severity of adverse effects can be increased when Decitabine is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Pemetrexed is combined with Decitabine. |
| Penicillamine | The risk or severity of adverse effects can be increased when Penicillamine is combined with Decitabine. |
| Pentosan polysulfate | The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Decitabine. |
| Pentostatin | The risk or severity of adverse effects can be increased when Pentostatin is combined with Decitabine. |
| Pentoxifylline | The risk or severity of bleeding can be increased when Pentoxifylline is combined with Decitabine. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Decitabine. |
| Phenindione | The risk or severity of bleeding can be increased when Phenindione is combined with Decitabine. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Phenol. |
| Phenprocoumon | The risk or severity of bleeding can be increased when Phenprocoumon is combined with Decitabine. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Decitabine. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Decitabine. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Decitabine is combined with Pirfenidone. |
| Polythiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Decitabine. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Decitabine is combined with Pomalidomide. |
| Ponatinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Ponatinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Decitabine is combined with Ponesimod. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Decitabine is combined with Pralatrexate. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Pramocaine. |
| Prasugrel | The risk or severity of bleeding can be increased when Prasugrel is combined with Decitabine. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Decitabine. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Decitabine. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Prilocaine. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Procaine. |
| Procarbazine | The risk or severity of adverse effects can be increased when Procarbazine is combined with Decitabine. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Proparacaine. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Propoxycaine. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Decitabine. |
| Protein C | The risk or severity of bleeding can be increased when Protein C is combined with Decitabine. |
| Protein S human | The risk or severity of bleeding can be increased when Protein S human is combined with Decitabine. |
| Rabies immune globulin | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Decitabine. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Decitabine. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Decitabine. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Decitabine. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Ravulizumab. |
| Reteplase | The risk or severity of bleeding can be increased when Reteplase is combined with Decitabine. |
| Reviparin | The risk or severity of bleeding can be increased when Reviparin is combined with Decitabine. |
| Rilonacept | The risk or severity of adverse effects can be increased when Decitabine is combined with Rilonacept. |
| Risankizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Risankizumab. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Decitabine. |
| Rivaroxaban | The risk or severity of bleeding can be increased when Rivaroxaban is combined with Decitabine. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Decitabine. |
| Ropeginterferon | The risk or severity of adverse effects can be increased when Decitabine is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Ropivacaine. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Decitabine. |
| Rubella virus vaccine | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Decitabine. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Ruxolitinib. |
| Sarilumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Sarilumab. |
| Satralizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Satralizumab. |
| Secukinumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Secukinumab. |
| Siltuximab | The risk or severity of adverse effects can be increased when Decitabine is combined with Siltuximab. |
| Siponimod | The risk or severity of adverse effects can be increased when Decitabine is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Decitabine. |
| Sirolimus | The risk or severity of adverse effects can be increased when Sirolimus is combined with Decitabine. |
| Smallpox | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Decitabine. |
| Sodium citrate | The risk or severity of bleeding can be increased when Sodium citrate is combined with Decitabine. |
| Sorafenib | The risk or severity of adverse effects can be increased when Sorafenib is combined with Decitabine. |
| Spesolimab | The risk or severity of adverse effects can be increased when Decitabine is combined with Spesolimab. |
| Streptokinase | The risk or severity of bleeding can be increased when Streptokinase is combined with Decitabine. |
| Streptozocin | The risk or severity of adverse effects can be increased when Streptozocin is combined with Decitabine. |
| Sulfamethoxazole | The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Decitabine. |
| Sulfasalazine | The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Decitabine. |
| Sulfinpyrazone | The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Decitabine. |
| Sulodexide | The risk or severity of bleeding can be increased when Sulodexide is combined with Decitabine. |
| Sunitinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Sunitinib. |
| Tacrolimus | Tacrolimus may increase the immunosuppressive activities of Decitabine. |
| Tedizolid phosphate | The risk or severity of myelosuppression can be increased when Decitabine is combined with Tedizolid phosphate. |
| Temozolomide | The risk or severity of adverse effects can be increased when Temozolomide is combined with Decitabine. |
| Temsirolimus | The risk or severity of adverse effects can be increased when Decitabine is combined with Temsirolimus. |
| Tenecteplase | The risk or severity of bleeding can be increased when Tenecteplase is combined with Decitabine. |
| Teniposide | The risk or severity of adverse effects can be increased when Teniposide is combined with Decitabine. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Teprotumumab. |
| Teriflunomide | The risk or severity of adverse effects can be increased when Decitabine is combined with Teriflunomide. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Decitabine is combined with Tetracaine. |
| Thalidomide | The risk or severity of adverse effects can be increased when Thalidomide is combined with Decitabine. |
| Thiotepa | The risk or severity of adverse effects can be increased when Decitabine is combined with Thiotepa. |
| Ticagrelor | The risk or severity of bleeding can be increased when Ticagrelor is combined with Decitabine. |
| Tick encephalitis | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Decitabine. |
| Ticlopidine | The risk or severity of bleeding can be increased when Ticlopidine is combined with Decitabine. |
| Tinzaparin | The risk or severity of bleeding can be increased when Tinzaparin is combined with Decitabine. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Decitabine. |
| Tirofiban | The risk or severity of bleeding can be increased when Tirofiban is combined with Decitabine. |
| Tixocortol | The risk or severity of adverse effects can be increased when Decitabine is combined with Tixocortol. |
| Tocilizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Tocilizumab. |
| Tofacitinib | Decitabine may increase the immunosuppressive activities of Tofacitinib. |
| Topotecan | The risk or severity of adverse effects can be increased when Topotecan is combined with Decitabine. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Decitabine. |
| Trabectedin | The risk or severity of adverse effects can be increased when Decitabine is combined with Trabectedin. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Decitabine. |
| Trastuzumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Trastuzumab emtansine. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Decitabine. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Decitabine. |
| Trichlormethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Decitabine. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Decitabine. |
| Triflusal | The risk or severity of bleeding can be increased when Triflusal is combined with Decitabine. |
| Trilostane | The risk or severity of adverse effects can be increased when Trilostane is combined with Decitabine. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Decitabine. |
| Typhoid Vaccine | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Decitabine. |
| Typhoid Vi | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Decitabine. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Decitabine is combined with Upadacitinib. |
| Urokinase | The risk or severity of bleeding can be increased when Urokinase is combined with Decitabine. |
| Varicella zoster vaccine | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Decitabine. |
| Varicella zoster | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Decitabine. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Decitabine is combined with Vedolizumab. |
| Vibrio cholerae | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Decitabine. |
| Vilanterol | The risk or severity of adverse effects can be increased when Decitabine is combined with Vilanterol. |
| Vinblastine | The risk or severity of adverse effects can be increased when Vinblastine is combined with Decitabine. |
| Vincristine | The risk or severity of adverse effects can be increased when Vincristine is combined with Decitabine. |
| Vindesine | The risk or severity of adverse effects can be increased when Vindesine is combined with Decitabine. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Vinorelbine is combined with Decitabine. |
| Voclosporin | The risk or severity of adverse effects can be increased when Decitabine is combined with Voclosporin. |
| Vorapaxar | The risk or severity of bleeding can be increased when Vorapaxar is combined with Decitabine. |
| Vorinostat | The risk or severity of adverse effects can be increased when Decitabine is combined with Vorinostat. |
| Warfarin | The risk or severity of bleeding can be increased when Warfarin is combined with Decitabine. |
| Ximelagatran | The risk or severity of bleeding can be increased when Ximelagatran is combined with Decitabine. |
| Yellow fever vaccine | The risk or severity of infection can be increased when Yellow fever vaccine is combined with Decitabine. |
Pregnancy and Lactation
US FDA pregnancy category Not Assigned
Pregnancy
If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus. Women of childbearing potential should be advised to use effective contraception and avoid becoming pregnant while being treated with this drug. The period following therapy when it is safe to become pregnant is unknown. Men should use effective contraception and be advised to not father a child while receiving this drug, and for 3 months following the last dose.
Lactation
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
How should this medicine be used?
Decitabine comes as a powder to be to be added to fluid and injected slowly over 3 hours intravenously (into a vein) by a doctor or nurse in a medical office or hospital outpatient clinic. It is usually injected every 8 hours for 3 days. This treatment period is called a cycle, and the cycle may be repeated every 6 weeks for as long as your doctor recommends. Decitabine should usually be given for at least four cycles but may be continued if your doctor decides that you will benefit from additional treatment.
Your doctor may also need to delay your treatment and reduce your dose if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with decitabine.
Your doctor will give you medication to prevent nausea and vomiting before you receive each dose of decitabine.
What special precautions should I follow?
Before receiving a dose of decitabine,
- tell your doctor and pharmacist if you are allergic to decitabine or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have kidney or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are using decitabine. You should use birth control to prevent pregnancy in yourself or your partner during your treatment with decitabine and for 2 months afterward. Talk to your doctor about birth control methods that will work for you. If you or your partner becomes pregnant while using decitabine, call your doctor. Decitabine may harm the fetus.
- tell your doctor if you are breastfeeding.
References
