lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Capsule
CAUTIONARY AND ADVISORY LABELS23, 25
▶Temozolomide (Non-proprietary)
Temozolomide 5 mgTemozolomide 5 mg capsules| 5 capsuleP
£ 10. 06 – £ 16. 00
Temozolomide 20 mgTemozolomide 20 mg capsules|
5 capsuleP£ 40. 23 – £ 65. 00
Temozolomide 100 mgTemozolomide 100 mg capsules|
5 capsuleP£ 201. 18 – £ 325. 00
Temozolomide 140 mgTemozolomide 140 mg capsules|
5 capsuleP£ 296. 47 – £ 465. 00
Temozolomide 180 mgTemozolomide 180 mg capsules|
5 capsuleP£ 381. 18 – £ 586. 00
Temozolomide 250 mgTemozolomide 250 mg capsules|
5 capsuleP£ 529. 42 – £ 814. 00
▶Temodal(Merck Sharp & Dohme Ltd)
Temozolomide 5 mgTemodal 5 mg capsules| 5 capsuleP
£ 10. 59 (Hospital only)
Temozolomide 20 mgTemodal 20 mg capsules| 5 capsuleP
£ 42. 35 (Hospital only)
Temozolomide 100 mgTemodal 100 mg capsules| 5 capsuleP
£ 211. 77 (Hospital only)
Temozolomide 140 mgTemodal 140 mg capsules| 5 capsuleP
£ 296. 48 (Hospital only)
Temozolomide 180 mgTemodal 180 mg capsules| 5 capsuleP
£ 381. 19 (Hospital only)
Temozolomide 250 mgTemodal 250 mg capsules| 5 capsuleP
£ 529. 43 (Hospital only)
▶Temomedac(medac UK)
Temozolomide 5 mgTemomedac 5 mg capsules| 5 capsuleP
£ 16. 12
Temozolomide 20 mgTemomedac 20 mg capsules| 5 capsuleP
£ 64. 49
Temozolomide 100 mgTemomedac 100 mg capsules|
5 capsuleP£ 322. 43
Temozolomide 140 mgTemomedac 140 mg capsules|
5 capsuleP£ 451. 40
Temozolomide 180 mgTemomedac 180 mg capsules|
5 capsuleP£ 580. 37
Temozolomide 250 mgTemomedac 250 mg capsules|
5 capsuleP£ 806. 08Thiotepa
lINDICATIONS AND DOSE
Conditioning treatment before haematopoietic stem cell
transplantation in the treatment of haematological
disease or solid tumours, in combination with other
chemotherapy
▶BY INTRAVENOUS INFUSION
▶Child:(consult local protocol)lCAUTIONSAvoid in Acute porphyrias p. 603
lINTERACTIONS→Appendix 1 : alkylating agents
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.anaemia.
appetite decreased.ataxia.bladder disorder.cardiac
arrest.cardiovascular insufficiency.diarrhoea.
encephalopathy.fever.gastrointestinal disorders.graft
versus host disease.growth retardation.haemorrhage.
headache.hearing impairment.heart failure.hepatic
failure.hyperglycaemia.hypertension.hypogonadism.
hypopituitarism.hypothyroidism.hypoxia.increased risk
of infection.intracranial haemorrhage.memory loss.
mucositis.multi organ failure.nausea.neutropenia.pain
.pancytopenia.paresis.psychiatric disorder.pulmonary
oedema.renal failure.respiratory disorders.secondary
malignancy.seizure.sepsis.sinusoidal obstruction
syndrome.skin reactions.stomatitis.thrombocytopenia.
vomiting▶Frequency not knownPulmonary arterial hypertension.
severe cutaneous adverse reactions (SCARs)
SIDE-EFFECTS, FURTHER INFORMATIONAlkylating drugs
can causefluid retention with oedema and dilutional
hyponatraemia in younger children; the risk of this
complication is higher in thefirst 2 days and also when
given with concomitant vinca alkaloids.
lCONCEPTION AND CONTRACEPTIONContraceptive advice
required, seePregnancy and reproductive functionin
Cytotoxic drugs p. 531.
lPREGNANCYAvoid (teratogenic and embryotoxic in
animals). See alsoPregnancy and reproductive functionin
Cytotoxic drugs p. 531.
lBREAST FEEDINGDiscontinue breast-feeding.
lNATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) Decisions
TheScottish Medicines Consortiumhas advised (June 2012 )
that thiotepa (Tepadina®)isnotrecommended for use
within NHS Scotland in combination with other
chemotherapy as conditioning treatment in adults or
children with haematological diseases, or solid tumours
prior to haematopoietic stem cell transplantation.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Powder for solution for infusion
▶Tepadina(Adienne Pharma & Biotech)
Thiotepa 15 mgTepadina 15 mg powder for concentrate for solution
for infusion vials| 1 vialPs
Thiotepa 100 mgTepadina 100 mg powder for concentrate for
solution for infusion vials| 1 vialPsANTINEOPLASTIC DRUGS›ANTHRACYCLINES
AND RELATED DRUGSDaunorubicin
lINDICATIONS AND DOSE
Acute myelogenous leukaemia|Acute lymphocytic
leukaemia
▶BY INTRAVENOUS INFUSION
▶Child:(consult local protocol)lUNLICENSED USEDaunoXome®is not licensed for use in
children.
lCONTRA-INDICATIONSMyocardial insufficiency.previous
treatment with maximum cumulative doses of
daunorubicin or other anthracycline.recent myocardial
infarction.severe arrhythmia
CONTRA-INDICATIONS, FURTHER INFORMATION
Anthracycline antibiotics should not normally be used in
children with left ventricular dysfunction.
lCAUTIONSCaution in handling—irritant to tissues
lINTERACTIONS→Appendix 1 : anthracyclines
lSIDE-EFFECTSAbdominal pain.alopecia.amenorrhoea.
anaemia.arrhythmias.ascites.atrioventricular block.
azoospermia.bone marrow disorders.cardiac
inflammation.cardiomyopathy.chills.congestive heart
failure.cyanosis.death.dehydration.diarrhoea.
dyspnoea.extravasation.fever.flushing.gastrointestinal
disorders.haemorrhage.hepatomegaly.hyperpyrexia.
hyperuricaemia.hypoxia.increased risk of infection.
ischaemic heart disease.leucopenia.mucositis.
myocardial infarction.nail discolouration.nausea.
nephropathy.neutropenia.oedema.pain.paraesthesia.
pleural effusion.radiation injuries.shock.skin reactions.
soft tissue necrosis.stomatitis.thrombocytopenia.
thrombophlebitis.urine red.vascular disorders.vomiting538 Cytotoxic responsive malignancy BNFC 2018 – 2019
Immune system and malignant disease8