Select a medication above to begin.
decitabine
generic
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments
- [formulation clarification]
- Info: do not substitute for PO decitabine/cedazurdine within a cycle
myelodysplastic syndrome
- [3-day regimen]
- Dose: 15 mg/m^2/dose IV q8h on days 1-3 of 42-day cycle; Info: give for at least 4 cycles
- [5-day regimen]
- Dose: 20 mg/m^2/dose IV x1 on days 1-5 of 28-day cycle; Info: give for at least 4 cycles
AML, newly diagnosed (off-label)
- [20 mg/m^2/dose IV x1 on days 1-5 of 28-day cycle]
- Info: for pts 75 yo and older, or who are ineligible for intensive induction chemo d/t comorbidities; use w/ venetoclax; cytoreduction may be required if WBC >25,000 prior to 1st dose
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy
- avoid: breastfeeding during tx and for at least 2wk after D/C
- caution: female pts of reproductive potential
- caution: male pts of reproductive potential
- caution: renal impairment
- caution: hepatic impairment
Drug Interactions .
Overview
decitabine
pyrimidine analog
- cytidine deaminase substrate
- CNT3 inhibitor
- ENT1 inhibitor
- hyperglycemic effects
- hyperkalemia
- hypokalemia
- immunosuppressive oncologic agent
- myelosuppressive oncologic agent
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- amiloride
- arsenic trioxide
- chloramphenicol
- cladribine oral
- deferiprone
- dexrazoxane
- etrasimod
- fexinidazole
- ganciclovir
- lisinopril
- olmesartan medoxomil
- palifermin
- penicillamine
- perindopril
- pimecrolimus topical
- potassium chloride
- potassium phosphate
- primaquine
- rabies vaccine
- radium Ra 223 dichloride
- ropeginterferon alfa-2b
- tacrolimus
- valganciclovir
Monitor/Modify Tx
- abiraterone acetate
- acarbose
- acetazolamide
- albendazole
- albuterol
- albuterol inhaled
- alemtuzumab
- aliskiren
- allopurinol
- aloe
- alogliptin
- amphotericin
- anthrax vaccine
- anti-thymocyte globulin
- arformoterol inhaled
- aripiprazole bimonthly injection
- asenapine
- asparaginase
- atidarsagene autotemcel
- auranofin
- azathioprine
- balsalazide
- baricitinib
- benazepril
- benznidazole
- betamethasone
- betibeglogene autotemcel
- bexagliflozin
- bromocriptine
- budesonide
- bumetanide
- canagliflozin
- candesartan cilexetil
- captopril
- carboplatin
- carfilzomib
- celecoxib
- cetuximab
- chlorothiazide
- chlorthalidone
- cidofovir
- cisplatin
- clozapine
- colchicine
- colesevelam
- corticotropin
- cortisone
- COVID-19 vaccine
- crizotinib
- cyclophosphamide
- cyclosporine
- dapagliflozin
- dapsone
- deferasirox
- deflazacort
- dexamethasone
- dichlorphenamide
- diclofenac
- diclofenac topical
- diflunisal
- digoxin
- dinutuximab
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- dulaglutide
- ebola vaccine, live
- eflapegrastim (G-CSF)
- elivaldogene autotemcel
- emapalumab
- empagliflozin
- enalapril
- enalaprilat
- epinephrine
- eplerenone
- ertugliflozin
- ethacrynic acid
- etodolac
- everolimus
- exagamglogene autotemcel
- exenatide
- fenoprofen
- filgrastim (G-CSF)
- finerenone
- flucytosine
- fludrocortisone
- fluphenazine
- flurbiprofen
- formoterol inhaled
- foscarnet
- fosinopril
- fostamatinib
- furosemide
- glimepiride
- glipizide
- glyburide
- Haemophilus b vaccine
- heparin
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydrochlorothiazide
- hydrocortisone
- hydroxychloroquine
- hydroxyurea
- ibuprofen
- ibuprofen lysine
- iloperidone
- indapamide
- indomethacin
- influenza H5N1 vaccine
- influenza vaccine
- insulin
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- irbesartan
- isoproterenol
- Japanese encephalitis vaccine
- ketoprofen
- ketorolac
- leflunomide
- lenalidomide
- levalbuterol inhaled
- licorice
- linagliptin
- linezolid
- liraglutide
- lonafarnib
- losartan
- lovotibeglogene autotemcel
- lumateperone
- lymphocyte immune globulin, anti-thymocyte globulin
- magnesium citrate
- mannitol
- meclofenamate
- mefenamic acid
- meloxicam
- meningococcal vaccine
- mercaptopurine
- mesalamine
- mesalamine rectal
- metformin
- methazolamide
- methotrexate
- methylprednisolone
- metolazone
- mifepristone
- moexipril
- motixafortide
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- naproxen
- nateglinide
- necitumumab
- nilotinib
- olodaterol inhaled
- olsalazine
- osilodrostat
- oxaprozin
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- pentamidine
- pioglitazone
- piroxicam
- pneumococcal vaccine
- poliovirus vaccine
- polyethylene glycol
- polyethylene glycol/electrolytes
- posaconazole
- potassium acid phosphate
- potassium bicarbonate
- potassium citrate
- potassium iodide
- pramlintide
- prednisolone
- prednisone
- proguanil
- pyrimethamine
- quinapril
- ramipril
- repaglinide
- respiratory syncytial virus vaccine
- ribavirin
- rituximab
- rosiglitazone
- ruxolitinib topical
- sacituzumab govitecan
- salmeterol inhaled
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- saxagliptin
- selinexor
- semaglutide
- sipuleucel-T
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- smallpox/mpox vaccine, live
- sodium benzoate
- sodium phenylacetate
- sodium phenylbutyrate
- sodium phosphate (bowel prep)
- sodium polystyrene sulfonate
- sodium thiosulfate
- sparsentan
- spironolactone
- stiripentol
- succimer
- sulfasalazine
- sulfate bowel prep
- sulindac
- tafasitamab
- telmisartan
- teplizumab
- terbutaline
- teriflunomide
- thalidomide
- tick-borne encephalitis vaccine
- tirzepatide
- tocilizumab
- tofacitinib
- tolmetin
- tolvaptan
- topiramate
- torsemide
- trandolapril
- trastuzumab
- triamcinolone
- triamterene
- trimethoprim
- typhoid vaccine
- upadacitinib
- valproic acid
- valsartan
- vamorolone
- vilanterol inhaled
- voclosporin
- zidovudine
- zonisamide
Caution Advised
- abatacept
- abrocitinib
- adalimumab
- anakinra
- anifrolumab
- avacopan
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- bimekizumab
- brodalumab
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- canakinumab
- certolizumab pegol
- danicopan
- deucravacitinib
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dimethyl fumarate
- diroximel fumarate
- dupilumab
- eculizumab
- efgartigimod alfa
- etanercept
- fingolimod
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- golimumab
- guselkumab
- hydrocortisone ophthalmic
- inebilizumab
- infliximab
- iptacopan
- ixekizumab
- loteprednol ophthalmic
- mirikizumab
- mitoxantrone
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- nadofaragene firadenovec intravesical
- natalizumab
- ocrelizumab
- ofatumumab
- ozanimod
- pegcetacoplan
- ponesimod
- pozelimab
- prednisolone ophthalmic
- ravulizumab
- rilonacept
- risankizumab
- ritlecitinib
- rozanolixizumab
- secukinumab
- siltuximab
- siponimod
- spesolimab
- sutimlimab
- tezepelumab
- tildrakizumab
- tralokinumab
- tuberculin purified protein derivative
- ublituximab
- ustekinumab
- vedolizumab
- vilobelimab
- zilucoplan
Adverse Reactions .
Serious Reactions
- neutropenia
- febrile neutropenia
- leukopenia
- thrombocytopenia
- anemia
- hemorrhage
- infection, serious
- splenomegaly
- renal failure
- atrial fibrillation
- MI
- CHF
- cardiorespiratory arrest
- pulmonary embolism
- hypersensitivity rxn
- anaphylaxis
- acute febrile neutrophilic dermatosis
- bone pain
- differentiation syndrome
- interstitial lung dz
Common Reactions
- myelosuppression
- fever
- nausea
- vomiting
- cough
- petechiae
- constipation
- diarrhea
- hyperglycemia
- headache
- insomnia
- peripheral edema
- hypoalbuminemia
- hypomagnesemia
- pallor
- rigors
- pneumonia
- hypokalemia
- ecchymosis
- arthralgia
- hyponatremia
- limb pain
- rash
- edema
- dizziness
- back pain
- cardiac murmur
- appetite decr.
- anorexia
- pharyngitis
- others: see pkg insert
Safety/Monitoring .
Monitoring Parameters
pregnancy test, Cr, LFTs at baseline; CBC w/ diff at baseline, before each cycle and as clinically indicated
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use during pregnancy; risk of fetal harm, incl. teratogenicity, based on limited human data and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x6mo after D/C in female pts and during tx and x3mo after D/C in male pts
Lactation
Clinical Summary
avoid breastfeeding during tx and for at least 2wk after D/C; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: deamination in liver, gut, granulocytes, blood; CYP450: none
Excretion: unknown; Half-life: 0.54-0.62h
Subclass: Antimetabolites, Pyrimidine Analogs ; Epigenetic Modifiers, DNA Methylation Inhibitors
Mechanism of Action
induces DNA hypomethylation, restoring normal tumor suppressor gene fxn and control of cellular differentiation and proliferation
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.