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Temodar (temozolomide)

This chemotherapy medication is given for a variety of brain tumors types, primarily gliomas. It may be prescribed at a lower dose for daily use during radiation therapy or at a higher dose when used for only five days per month.

Temodar is usually the first line of chemotherapy drug used to treat gliomas. As long as you tolerate the chemotherapy well, and MRIs show no evidence of a growing tumor, then you may take Temodar for 12 cycles. It can be used safely for up to 24 cycles.

How is Temodar supplied

Temodar is supplied in 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, and 250 mg capsules.

How should I take Temodar

  • Take nausea medicine (e.g., Kytril, Zofran or Anzemet) one hour before taking Temodar to combat anticipated side effect of nausea.
  • Take Temodar on an empty stomach.
    • Do not eat or drink anything for one hour before or after chemotherapy.
  • Take at bedtime with a glass of water.
    • It is better to take this particular chemotherapy drug at bedtime as there are fewer meals to plan around and IF you were to feel bad from the medication, you will be able to sleep through it.
  • Contact your neuro-oncology team if you miss a dose (do not double dose).

What are common side effects of Temodar and how can I manage them?

  1. Constipation
    Take a stool softener and/or a stimulant (i.e. MiraLAX) as needed to keep your bowels regular. All patients experience some degree of constipation while on Temodar.
  2. Nausea
    Take Kytril or Zofran at least once a day prior to chemotherapy, but more often if needed. There are also other drugs available to help with nausea if needed.
  3. Bone marrow suppression (a decrease in WBC, RBC, PLT)
    • White Blood Cells (WBC) – infection fighters
      Neutrophils (a type of white blood cell) may be lowest 21 days after treatment and should recover by day 28.  If you are taking Temodar daily, you should have your blood tested weekly and take a medicine to protect you from pneumocystis pneumonia (PCP). Temodar affects your lymphocytes (types of white blood cell) and can put you at risk for this PCP.
    • Red Blood Cells (RBC) – oxygen carriers
      Anemia may worsen over a period of months. Rarely, a patient may need a blood transfusion.
    • Platelets (PLT) – blood-clotting cells
      In some cases, patients may need a platelet transfusion.
  4. Fatigue
    Fatigue associated with Temodar is usually manageable for most patients. Fatigue may worsen during the week of chemotherapy, but for some patients the fatigue may linger for one  week or longer after treatment is completed. Talk to your healthcare provider if fatigue is interfering with your daily life.