Dacarbazine

Immunisation with live vaccines should be avoided during therapy with dacarbazine due to the risk of serious and potentially fatal infections. It is advised to use live virus vaccines with caution after stopping chemotherapy and vaccinate not sooner than 3 months after the last dose of chemotherapy. It is recommended to use an inactivated vaccine if available.

Risk of thrombosis is increased in malignant diseases; therefore, use of concomitant anticoagulation is common. If the patient is to receive oral anticoagulants, the frequency of INR monitoring must be increased due to large interindividual variability in coagulation and due to possible interaction between anticoagulants and cytostatics.

Concomitant use of cyclosporine (and in some cases tacrolimus) must be considered carefully because these agents may cause excessive immunosuppression and lymphoproliferation.

Concomitant use of fotemustine can cause acute pulmonary toxicity (adult respiratory distress syndrome). Fotemustine and dacarbazine should not be used concomitantly.

Concomitant use of dacarbazine with phenytoin may cause reduced absorption of phenytoin from the gastrointestinal tract and may predispose the patient to convulsions.

Dacarbazine has been shown to be mutagenic, teratogenic and carcinogenic in animals. It must be assumed that an increased risk for teratogenic effects exists in humans. Therefore Dacarbazine medac is contraindicated during pregnancy.

Women of child-bearing potential have to use effective contraception during treatment.

Dacarbazine medac is contraindicated during breast-feeding.

Dacarbazine may influence the ability to drive or operate machines because of its central nervous side effects or because of nausea and vomiting.