Azacitidine

Uses	Myelodysplastic Syndromes And Acute Myeloid Leukaemia
Therapy	Anti-Neoplastic
Side Effects	Low Blood Counts, Nausea, Constipation, Injection Site Reactions

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Molecule Description

Azacitidine is an anti-cancer medicine. Azacitidine belongs to a class of medicines called nucleoside metabolic inhibitors. It is used as continued (maintenance) treatment in adult patients with acute myeloid leukaemia (AML). Oral Azacitidine used in patients who achieved first complete remission or complete remission with incomplete blood count recovery (CR or CRi) following intensive induction chemotherapy, but are unable to complete intensive curative therapy. Do not substitute oral azacitidine for injectable azacitidine because their indications and dosing schedules differ. Azacitine injection is used in management of adult patients with all subtypes of Myelodysplastic Syndrome. Azacitidine works by being incorporated into DNA and RNA, where it interferes with DNA methylation and RNA metabolism. This disrupts the growth and survival of leukaemia cells and can ultimately lead to their death. Take the medicine as prescribed by your doctor. Azacitidine can lower your white blood cell count; any fever, chills, or feeling unwell during treatment requires urgent medical attention. Azacitidine can cause side effects like nausea, vomiting, diarrhoea, or loss of appetite, and it also affects the bone marrow. Warning signs that need prompt medical review include fever, unusual bruising or bleeding, black or bloody stools, or breathlessness. Before starting treatment, tell your doctor about any kidney or liver problems, any pregnancy or plans for pregnancy, and all other medicines, supplements, or herbal products you take. Azacitidine can cause dizziness, tiredness, or weakness in some people, so be careful with driving or operating machinery.

Uses

Azacitidine tablets is used for continued (maintenance) treatment in patients with acute myeloid leukaemia (AML) and azacitidine injection is used in the management of adult patients with all subtypes of Myelodysplastic Syndrome.

Contraindications

When should one not use Azacitidine

Known severe allergic (hypersensitivity) reaction to Azacitidine or to any of the ingredients of the formulation.

Side effects

Common side effects of this drug are:

Nausea and vomiting
Diarrhoea
Tiredness or weakness (fatigue)
Constipation
Stomach (abdominal) pain
Joint pain
Reduced appetite
Pain in the arms or legs
Dizziness
Low white blood cell count with fever (febrile neutropenia)
Infections, including upper respiratory tract infection and pneumonia
Unexplained weight loss
Low blood cell counts noticed only on blood tests (without symptoms)
Skin infection.
Fever, chills, body aches, unusual tiredness, or new headache
Unusual bruising, bleeding gums, blood in urine or stool, or tiny red/purple spots on the skin.
Severe or persistent vomiting or diarrhoea that stops you from keeping fluids down
Sudden shortness of breath, chest pain, or a new cough with fever.
Signs of a severe allergic reaction.
Do not stop or change your treatment because of a side effect without speaking to your doctor first.

Precautions and Warnings

Pregnancy

No, Azacitidine is not recommended during pregnancy because it can harm a developing baby. Discuss effective contraception with your doctor before starting treatment and follow your doctor’s recommendations for contraception

Breast Feeding

No, breastfeeding is not recommended during treatment because of the potential for serious side effects in a breastfeeding baby. Discuss with your doctor when you can safely resume breastfeeding.

Driving

Azacitidine may cause dizziness, fatigue, or weakness. If you experience these symptoms, avoid driving or operating machinery and speak with your healthcare professional if they are severe or persistent.

Alcohol

It is best to avoid alcohol during your treatment course. If you have questions about whether any amount of alcohol is safe for you, speak to your oncologist before making that decision.

Other General Warnings

Talk to your doctor if

If you have low blood counts or bone marrow problems
If you have a history of severe allergic reactions to any medicine
If you have plans for pregnancy, or have fertility concerns
If you have kidney or liver disease
If you have any recent or ongoing infection
If you tend to bruise or bleed easily.
If you have any other serious medical condition

Mode of Action

How Does It Work?

Azacitidine is an anticancer medicine in the nucleoside metabolic inhibitor class. After absorption, the body converts Azacitidine into active metabolites that become incorporated into DNA and RNA. By interfering with DNA methylation and RNA metabolism, Azacitidine alters gene activity and disrupts the growth and survival of leukaemia cells. These effects can reduce the ability of remaining leukaemia cells to survive and multiply after remission.

Interactions

Interactions with other medicines

Always tell your doctor about every prescription medicine, over-the-counter medicine, vitamin, and herbal or dietary supplement you are taking so they can review your full treatment for safety.

Interactions with food items

No known interaction with food.

Dosage

Overdose

If an overdose is suspected, seek immediate medical attention. There is no specific antidote for azacitidine overdose, and management is supportive with appropriate monitoring and treatment of symptoms and complications.

Missed a Dose

If you miss your scheduled session, contact your doctor or clinic as soon as possible. Your healthcare team will determine when your next dose should be given.

Frequently Asked Questions (FAQs)

Hair loss is not among the most common adverse reactions of Azacitidine. If you notice hair loss or other unexpected symptoms during treatment, discuss them with your healthcare team.

Yes, Azacitidine is a chemotherapy medicine used to treat cancer. It interferes with DNA synthesis in cancer cells, which may help to reduce their growth and multiplication.

Common side effects of Azacitidine include nausea, vomiting, diarrhoea, constipation, tiredness, decreased appetite, rash, skin redness, dizziness, joint pain, headache, sore throat, and nose-related symptoms.