Temozolomide
Brand Names: Temodar
Methodology & AI Transparency ⓘ
Temozolomide Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Temozolomide is an alkylating drug indicated for the treatment of adults with: Newly diagnosed glioblastoma concomitantly with radiotherapy and then as maintenance treatment.
- 2 Real-world patient consensus: Tracked across 21 patient dosage logs with a 78% satisfaction benchmark (RxCUI 313209).
- 3 Typical cash cost range: 30-day cash pricing ranges from $19.91 on Cost Plus Drugs to $48.78 walk-in retail (NADAC $1.9313/unit).
- 4 Top reported side effects / signs: Leading openFDA/SPL adverse events for Temozolomide: nausea (10%), headache (8.6%), fatigue (7.7%).
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Temozolomide Mechanism, CYP450 Pathways & DailyMed Monograph
Temozolomide is an alkylating drug indicated for the treatment of adults with: Newly diagnosed glioblastoma concomitantly with radiotherapy and then as maintenance treatment. ( 1.1 ) Anaplastic astrocytoma. ( 1.2 ) Adjuvant treatment of adults with newly diagnosed anaplastic astrocytoma. ( 1.2 ) Treatment of adults with refractory anaplastic astrocytoma. ( 1.2 ) 1.1 Newly Diagnosed Glioblastoma Temozolomide capsules are indicated for the treatment of adults with newly diagnosed glioblastoma, concomitantly with radiotherapy and then as maintenance treatment.
12.1 Mechanism of Action Temozolomide is not directly active but undergoes rapid nonenzymatic conversion at physiologic pH to the reactive compound 5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide (MTIC). The cytotoxicity of MTIC is thought to be primarily due to DNA alkylation, mainly at the O 6 and N 7 positions of guanine, which causes DNA double strand breaks and results in programmed cell death. 12.2 Pharmacodynamics Temozolomide exposure-response relationships and the time course of pharmacodynamic response are unknown.
Following administration (140 mg/1 Capsule), Temozolomide achieves F ≈ 63%–75% systemic availability after standard oral Temozolomide administration bioavailability and time to peak concentration spans 1 to 4 hrs under temozolomide maintenance onset, governed by a Terminal t½ estimated at 4–10 hrs depending on renal/hepatic reserve (Temozolomide) terminal half-life through mixed metabolic conjugation and unchanged urinary excretion across temozolomide regimens.
Before initiating Temozolomide at 140 mg/1 Capsule, clinical safety checklists rule out temozolomide is contraindicated in patients with a history of serious hypersensitivity reactions to: temozolomide or any other ingredients in temozolomide capsules; and dacarbazine, since both temozolomide and dacarbazine are metabolized to the same active metabolite 5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide.. Logged tolerability patterns center on nausea (10% of reports), headache (8.6% of reports), constipation (8.1% of reports).
Assess baseline hepatic panels and interacting prescriptions when starting Temozolomide (alkylating drug).
Alcohol or high-fat meal timing can shift absorption rate and orthostatic tolerance during Temozolomide dosing.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- Temozolomide is contraindicated in patients with a history of serious hypersensitivity reactions to: temozolomide or any other ingredients in temozolomide capsules
- and dacarbazine, since both temozolomide and dacarbazine are metabolized to the same active metabolite 5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide.
Logged Side-Effect Incidence (21 Reports)
Temozolomide Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Temozolomide)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| Can This Approach Help? Inside the Latest Research on Early onset radiation-induced leukoencephalopathy in patients treated for a This study reports a high incidence (29%) of early-onset RIL in glioblastoma patients treated with the Stupp protocol, highlighting the question of individual sensitivity to this severe side effect. Revue neurologique • 2026-03-15 • Phase III Randomized Trial | Multi-cohort | 88/100 | PMID 41644378 ↗ |
| New Insights on Phase III study of short-course radiotherapy combined with Temozolomide in older: What a 270-Participant Study Found Date of Registration: 27/Aug/2020. BMC cancer • 2021-10-15 • Phase III Randomized Trial | N = 270 | 87/100 | PMID 34654402 ↗ |
| Can This Approach Help? Inside the Latest Research on Phase III study of high-dose methotrexate and whole-brain radiotherapy This study failed to demonstrate the benefit of concomitant and maintenance TMZ in newly diagnosed PCNSL. Neuro-oncology • 2023-04-06 • Phase III Randomized Trial | N = 134 | 82/100 | PMID 36334050 ↗ |
| Can This Approach Help? Inside the Latest Research on Patterns, predictors and prognostic relevance of high-grade hematotoxicity after Older age and female sex are associated with higher incidence of HAE. Journal of neuro-oncology • 2023-01-15 • Phase III Randomized Trial | Multi-cohort | 82/100 | PMID 36609807 ↗ |
| Can This Approach Help? Inside the Latest Research on A Phase 3b Study for Management of Ocular Side Effects in Patients with Epidermal The premature cessation of the study precludes definitive conclusions regarding the OSE prophylaxis strategies. Ophthalmic research • 2023-01-15 • Phase III Randomized Trial | Multi-cohort | 82/100 | PMID 37257422 ↗ |
Temozolomide Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $1.9313/unit (~$57.94/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $19.91 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $48.78 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 21 Anonymous DotMD Community Micro-Logs | $22.90 / mo | View logs ↓ |
Temozolomide Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Temozolomide RxNorm Concept ID | 313209 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $1.9313 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $48.78 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $19.91 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 78.00% Worth It (21 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Temozolomide Patient Community, Cohort Filters & Dosage Logs
Federal clinical ledger for Temozolomide integrating DailyMed SPL (2024-07-25), CMS NADAC ($1.9313/unit), and 21 Zero-PHI patient logs.
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Temozolomide community threads and patient logs by age, biological sex, dosage, and treatment duration.