Why is this medication prescribed?

Decitabine and cedazuridine are often prescribed together as a combination treatment for certain types of blood cancers, particularly myelodysplastic syndromes (MDS), including chronic myelomonocytic leukemia (CMML). This combination medication is intended for use in adult patients who are ineligible for intensive induction chemotherapy.

Decitabine is a chemotherapy drug that works by interfering with the growth and spread of cancer cells in the body. It is a type of medication known as a nucleoside metabolic inhibitor.

Cedazuridine is a cytidine deaminase inhibitor. It helps to increase the amount of decitabine in the bloodstream by blocking the breakdown of decitabine in the gut and liver, thereby enhancing its effectiveness.

How should this medicine be used?

Decitabine and cedazuridine are typically prescribed together as a combination treatment for certain types of blood cancers, particularly myelodysplastic syndromes (MDS), including chronic myelomonocytic leukemia (CMML), in adult patients who are ineligible for intensive induction chemotherapy. The combination is administered orally as tablets, and the recommended dosage and schedule are as follows:

• Dosage: The standard dosage of the combination tablet contains 35 mg of decitabine and 100 mg of cedazuridine.
• Schedule: The tablets are taken once daily for five consecutive days of each 28-day treatment cycle. This cycle is repeated until the disease progresses or unacceptable toxicity occurs.
• Administration: The tablets should be swallowed whole with water, without chewing, crushing, or breaking them. They can be taken with or without food.
• Timing: It’s important to take the tablets at approximately the same time each day to maintain consistent levels of the medication in the bloodstream.
• Duration of Treatment: The duration of treatment may vary depending on the individual patient’s response to therapy and their overall health status. Your healthcare provider will determine the appropriate duration of treatment for you.
• Monitoring: Throughout the treatment course, regular monitoring of blood counts and liver function tests may be necessary to assess the response to treatment and detect any potential side effects.
• Adherence: It’s essential to adhere to the prescribed dosage and schedule exactly as instructed by your healthcare provider. Do not adjust the dosage or stop taking the medication without consulting your healthcare provider first.
• Side Effects: Be aware of potential side effects of the medication and report any unusual symptoms or concerns to your healthcare provider promptly. These may include but are not limited to, changes in blood counts, nausea, vomiting, diarrhea, fatigue, and liver function abnormalities.

Always consult with your healthcare provider or pharmacist if you have any questions or concerns regarding the use of decitabine and cedazuridine or any other medications prescribed to you.

Other uses for this medicine

Decitabine and cedazuridine are primarily used in combination for the treatment of certain types of blood cancers, particularly myelodysplastic syndromes (MDS), including chronic myelomonocytic leukemia (CMML), in adult patients who are ineligible for intensive induction chemotherapy. However, there are no other approved uses for this combination medication as of my last update.

What special precautions should I follow?

As for special precautions when using decitabine and cedazuridine, here are some important considerations:

• Medical History: Before starting treatment, inform your healthcare provider about your complete medical history, including any allergies, pre-existing conditions (especially kidney or liver problems), ongoing treatments, and medications (prescription, non-prescription, herbal, or dietary supplements) you are currently taking.
• Pregnancy and Breastfeeding: Decitabine and cedazuridine may cause harm to an unborn baby. Therefore, it’s crucial to avoid pregnancy during treatment and for at least 6 months after the last dose. If you are pregnant or planning to become pregnant, discuss the potential risks and benefits of this medication with your healthcare provider. It is also not recommended during breastfeeding.
• Liver and Kidney Function: Decitabine and cedazuridine may affect liver and kidney function. Regular monitoring of liver and kidney function tests may be necessary during treatment. Your healthcare provider will determine if any dosage adjustments are needed based on your individual condition.
• Blood Counts: Treatment with decitabine and cedazuridine may cause a decrease in blood cell counts (red blood cells, white blood cells, and platelets). Regular blood tests will be required to monitor these counts. Inform your healthcare provider immediately if you experience symptoms such as unusual bleeding or bruising, fever, or signs of infection.
• Drug Interactions: Before taking any new medications (prescription, over-the-counter, herbal, or dietary supplements) during treatment with decitabine and cedazuridine, consult your healthcare provider or pharmacist to avoid potential drug interactions.
• Driving and Operating Machinery: Decitabine and cedazuridine may cause dizziness or drowsiness as side effects. Avoid driving, operating machinery, or engaging in activities requiring alertness until you know how this medication affects you.
• Handling Precautions: Handle the tablets with care and avoid direct contact with the skin or mucous membranes. If the tablets are broken or crushed accidentally, wash hands thoroughly with soap and water immediately.
• Storage: Store decitabine and cedazuridine tablets at room temperature away from moisture, heat, and light. Keep them out of reach of children and pets.

Always follow your healthcare provider’s instructions and guidelines for the safe and effective use of decitabine and cedazuridine. If you have any questions or concerns, don’t hesitate to discuss them with your healthcare provider or pharmacist.

What special dietary instructions should I follow?

• There are no specific dietary restrictions associated with Decitabine and cedazuridine. However, maintaining a healthy and balanced diet can support your overall well-being during treatment.
• Stay hydrated by drinking plenty of fluids unless otherwise advised by your healthcare provider, especially if you experience diarrhea or vomiting as side effects.

What should I do if I forget a dose?

• If you miss a dose of Decitabine and cedazuridine, take it as soon as you remember, unless it’s close to the time for your next scheduled dose.
• Do not take a double dose to make up for a missed one. Instead, resume your regular dosing schedule.
• If you’re unsure about what to do, or if you miss multiple doses, contact your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Decitabine and cedazuridine, like any medication, can cause side effects. Some common side effects may include:

• Low Blood Cell Counts: This can lead to symptoms such as fatigue, weakness, shortness of breath, easy bruising or bleeding, and increased susceptibility to infections.
• Nausea and Vomiting: These gastrointestinal symptoms are common but are usually mild to moderate in severity.
• Diarrhea or Constipation: Changes in bowel habits can occur during treatment.
• Fatigue: Feeling tired or lethargic is a common side effect.
• Injection Site Reactions: If receiving the injectable form, redness, swelling, or pain at the injection site may occur.
• Liver Function Abnormalities: Decitabine and cedazuridine can affect liver function, leading to elevated liver enzymes in blood tests. Symptoms may include jaundice (yellowing of the skin or eyes) and abdominal pain.
• Nervous System Effects: Some patients may experience dizziness, headache, or confusion.
• Fever: Low-grade fever may occur, especially during the first few days of treatment.
• Loss of Appetite: Some patients may experience a decreased desire to eat.
• Muscle or Joint Pain: Pain or discomfort in muscles or joints may occur.
• Rash or Skin Irritation: Skin reactions such as rash or itching may occur.
• Hair Loss (Alopecia): Hair thinning or loss may occur, but it is usually temporary.

It’s important to note that not all patients will experience these side effects, and the severity can vary from person to person. Additionally, some side effects may require medical attention, while others may resolve on their own as your body adjusts to the medication.

If you experience any side effects while taking Decitabine and cedazuridine, it’s crucial to inform your healthcare provider promptly. They can provide guidance on managing side effects and may adjust your treatment regimen if necessary.

What should I know about storage and disposal of this medication?

Storage and disposal of Decitabine and cedazuridine:

• Storage:
  • Store Decitabine and cedazuridine tablets at room temperature, away from moisture, heat, and light.
  • Keep the medication in its original container and out of reach of children and pets.
  • Do not freeze the tablets.
  • Avoid storing the medication in the bathroom, where it may be exposed to moisture and humidity.
• Disposal:
  • Dispose of any unused or expired Decitabine and cedazuridine tablets properly.
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
  • Consult your pharmacist or local waste disposal facility for guidance on how to dispose of medications safely.

In case of emergency/overdose

• In case of an overdose or emergency, such as accidentally taking too much Decitabine and cedazuridine, seek immediate medical attention or contact a poison control center.
• Symptoms of overdose may include severe nausea, vomiting, diarrhea, increased risk of infection due to low blood cell counts, and liver toxicity.

What other information should I know?

• Keep all appointments with your healthcare provider for regular monitoring and blood tests during treatment.
• Inform all healthcare providers involved in your care that you are taking Decitabine and cedazuridine.
• Avoid situations that may increase the risk of infection, such as being around people who are sick or in crowded places, as your immune system may be weakened during treatment.
• Carry a medical alert card or bracelet indicating that you are taking Decitabine and cedazuridine in case of emergencies.
• Do not share your medication with others, even if they have similar symptoms or conditions.
• Follow your healthcare provider’s instructions and guidelines for the safe and effective use of Decitabine and cedazuridine.
• Report any new or worsening symptoms to your healthcare provider promptly.

By following these storage, disposal, emergency response, and other essential guidelines, you can ensure the safe and effective use of Decitabine and cedazuridine as prescribed by your healthcare provider. If you have any questions or concerns, don’t hesitate to discuss them with your healthcare provider or pharmacist.