Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Temozolomide
Drug ID BADD_D02150
Description Refractory anaplastic astrocytoma (WHO grade III) and Glioblastoma multiforme (WHO grade IV) are primary malignant brain tumours with poor prognosis and limited treatment options. Despite considerable genetic heterogeneity, these tumours often have impaired DNA repair systems, rendering them initially sensitive to alkylating agents, although they invariably develop resistance to these agents over time.[A229848, A229858, L32033] Temozolomide is an imidazotetrazine prodrug that is stable at acidic pH but undergoes spontaneous nonenzymatic hydrolysis at neutral or slightly basic pH; these properties allow for both oral and intravenous administration.[A229853, A229888, A229923, L32033] Following initial hydrolysis, further reactions liberate a highly reactive methyl diazonium cation capable of methylating various residues on adenosine and guanine bases leading to DNA lesions and eventual apoptosis.[A229853, A229923] Temozomolide as an adjunct to radiotherapy followed by maintenance dosing remains the standard of care for both Glioblastoma and refractory anaplastic astrocytoma.[L32033] Temozolomide was granted FDA approval on August 11, 1999, as an oral capsule and subsequently on February 27, 2009, as an intravenous injection. It is currently marketed under the trademark TEMODAR® by Merck.[L32033]
Indications and Usage Temozolomide is indicated in adult patients for the treatment of newly diagnosed glioblastoma concomitantly with radiotherapy and for use as maintenance treatment thereafter. It is also indicated for the treatment of refractory anaplastic astrocytoma in adult patients who have experienced disease progression on a drug regimen containing nitrosourea and procarbazine.[L32033]
Marketing Status approved; investigational
ATC Code L01AX03
DrugBank ID DB00853
KEGG ID D06067
MeSH ID D000077204
PubChem ID 5394
TTD Drug ID D0C8EU
NDC Product Code 75834-143; 29902-0009; 68554-0048; 16729-050; 16729-129; 23155-774; 47335-890; 70771-1092; 75834-142; 16571-818; 0085-1366; 23155-779; 47335-893; 47335-929; 65162-802; 67877-539; 70771-1093; 16571-816; 0085-3004; 16729-049; 47335-930; 50268-761; 64980-337; 65162-806; 68382-754; 70771-1096; 64980-335; 64980-338; 65162-801; 65162-805; 67877-540; 67877-542; 68382-755; 70771-1097; 75834-144; 46014-1450; 0085-1519; 75834-146; 58175-0411; 16571-820; 0085-1425; 0085-1430; 23155-777; 47335-891; 64980-336; 67877-538; 68382-752; 70771-1094; 75834-132; 16571-821; 16729-130; 67877-541; 68382-753; 68382-756; 75834-145; 46014-1121; 50683-0485; 53104-7697; 16729-051; 50268-762; 64980-333; 65162-804; 67877-537; 68382-751; 70771-1095; 14778-1414; 66499-0015; 0085-1417; 23155-778; 64980-334; 81955-0014; 82920-703; 16571-817; 16571-819; 16729-048; 23155-775; 23155-776; 65162-803; 50683-0185; 0085-1381; 47335-892
UNII YF1K15M17Y
Synonyms Temozolomide | 8-Carbamoyl-3-methylimidazo(5,1-d)-1,2,3,5-tetrazin-4(3H)-one | Methazolastone | Temodal | Temodar | Temozolomide Hexyl Ester | TMZA-HE | CCRG 81045 | CCRG-81045 | CCRG81045 | TMZ-Bioshuttle | TMZ Bioshuttle | NSC 362856 | NSC-362856 | NSC362856 | M&B 39831 | M&B-39831 | M&B39831
Chemical Information
Molecular Formula C6H6N6O2
CAS Registry Number 85622-93-1
SMILES CN1C(=O)N2C=NC(=C2N=N1)C(=O)N
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice.
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Disease progression08.01.03.0380.017047%
Disease recurrence08.01.03.0500.005731%-
Diverticular perforation07.04.04.0080.000112%-
Drug intolerance08.06.01.013---
Neoplasm recurrence16.16.02.0040.001310%-
Hepatobiliary disease09.01.08.003---
Pigmentation disorder23.05.03.001---
Metastasis16.22.01.0010.000470%-
Hypophagia07.01.06.010; 14.03.01.006; 19.09.01.0040.000448%-
Bone marrow failure01.03.03.0050.002966%
Cytopenia01.03.03.0120.000168%-
Acute interstitial pneumonitis22.01.02.0160.000112%-
Treatment failure08.06.01.0170.004097%-
Liver injury09.01.07.022; 12.01.17.0120.000336%-
Organising pneumonia22.01.02.0080.000839%-
Adverse reaction08.06.01.018---
Oral disorder07.05.01.0050.000112%-
Brain injury17.11.01.003; 19.07.03.0070.000448%-
Traumatic liver injury09.01.08.010; 12.01.17.027---
Hypertransaminasaemia09.01.02.0050.000336%-
Neurological decompensation17.02.05.0300.000112%-
Drug-induced liver injury09.01.07.023; 12.03.01.0440.000772%-
White matter lesion17.11.01.009; 24.04.06.0270.000112%-
Drug reaction with eosinophilia and systemic symptoms10.01.01.021; 12.03.01.064; 23.03.05.0050.000951%-
Pneumocystis jirovecii pneumonia11.03.07.005; 22.07.08.009---
Candida infection11.03.03.021--
Anal incontinence07.01.06.029; 17.05.01.0210.000168%
B precursor type acute leukaemia01.10.01.004; 16.01.01.0040.000112%-
Brain neoplasm malignant16.30.04.002; 17.20.04.0020.000862%-
Gliosis17.06.01.0040.000112%-
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