Products
Decitabine is commercially available as a lyophilizate for the preparation of a concentrate for infusion solution (Dacogen). It has been approved in many countries and in the EU since 2012.
Structure and properties
Decitabine (C8H12N4O4, Mr = 228.2 g/mol) or 5-aza-2′-deoxycytidine is an analog of cytidine deoxynucleoside and differs from deoxycytidine by a C substitution in position 5 of the pryridine ring by a nitrogen atom. It exists as a fine, white powder. Deoxycytidine is a prodrug that is metabolized in the body to triphosphate.
Effects
Decitabine (ATC L01BC08) has cytotoxic properties. The effects are due to inhibition of DNA methyltransferases. This causes gene promoters to become less methylated (hypomethylation of DNA), which ultimately induces apoptosis and cell death.
Indications
As a second-line agent for the treatment of adult patients with acute myeloid leukemia (AML).
Dosage
According to the SmPC. The drug is administered as an intravenous infusion.
Contraindications
- Hypersensitivity
- Breastfeeding
Full precautions can be found in the drug label.
Adverse effects
The most common possible adverse effects include fever, gastrointestinal symptoms (nausea, diarrhea), and hematologic disorders (anemia, thrombocytopenia, neutropenia, febrile neutropenia, leukopenia).
