Azacitidine
About Azacitidine
Azacitidine is a prescription anticancer medicine used to treat certain blood and bone marrow disorders, including myelodysplastic syndromes (MDS), chronic myelomonocytic leukaemia (CMML), and some types of acute myeloid leukaemia (AML). It works by slowing the growth of abnormal bone marrow cells and helping restore the production of healthy blood cells, which can improve blood counts and reduce disease progression.
This medicine is administered as an injection by a trained healthcare professional, either under the skin (subcutaneously) or into a vein (intravenously). Treatment is usually given in repeated cycles consisting of several consecutive treatment days followed by a rest period. It is important to attend every scheduled appointment and complete each treatment cycle exactly as prescribed, even if you begin to feel better.
During treatment, your doctor will perform regular blood tests to monitor your red blood cells, white blood cells, platelets, and kidney and liver function. Because Azacitidine temporarily lowers blood cell counts, you may become more susceptible to infections, bleeding, or anaemia. Contact your doctor immediately if you develop a fever, chills, unusual bruising or bleeding, severe fatigue, persistent shortness of breath, or any other signs of infection.
Before starting treatment, tell your doctor if you have kidney disease, liver disease, heart disease, or a history of severe infections. This medicine should not be used if you are allergic to azacitidine or mannitol, or if you have advanced malignant liver tumours.
Azacitidine can interact with other medicines that suppress the immune system or affect blood clotting, increasing the risk of infections or bleeding. Avoid receiving live vaccines during treatment unless your doctor specifically recommends them. This medicine may harm an unborn baby, so effective contraception is recommended during treatment and for some time after the last dose. Breastfeeding should be avoided throughout treatment and for at least one week after the final dose. Older adults generally tolerate this medicine well but may require closer monitoring of kidney function and blood counts.
Uses of Azacitidine
Medicinal Benefits
When taken as prescribed, Azacitidine offers several important benefits in the treatment of certain blood cancers and bone marrow disorders.
- Improves healthy blood cell production: By reducing the growth of abnormal bone marrow cells, this medicine allows healthier red blood cells, white blood cells, and platelets to develop, helping improve overall blood function.
- Reduces the need for blood transfusions: Many patients experience improved blood counts during treatment, decreasing their dependence on repeated red blood cell or platelet transfusions.
- Helps lower the risk of complications: By improving blood cell production, Azacitidine may reduce symptoms such as severe fatigue from anaemia, frequent infections caused by low white blood cell counts, and excessive bruising or bleeding due to low platelet levels.
- Slows disease progression: Regular treatment helps control the growth of abnormal bone marrow cells, delaying disease progression and helping maintain a better quality of life for many patients.
Directions for Use
- Follow your doctor's instructions on the dosage and timing of this medication.
- Azacitidine will be administered by a nurse or doctor.
- Do not self-administer.
Storage
Side Effects of Azacitidine
Common Side Effects (Usually mild):
- Nausea or vomiting
- Loss of appetite
- Constipation or diarrhoea
- Fatigue or weakness
- Fever
- Injection-site pain, redness, bruising, or swelling
- Low blood cell counts (anaemia, neutropenia, or thrombocytopenia)
Serious Side Effects (Seek immediate medical attention):
- High fever, chills, persistent sore throat, or other signs of serious infection
- Unusual bruising, prolonged bleeding, nosebleeds, or blood in the urine or stools
- Severe shortness of breath, chest pain, or rapid heartbeat
- Yellowing of the skin or eyes, dark urine, or severe abdominal pain (possible liver injury)
- Severe allergic reaction with swelling of the face, lips, tongue, or throat, difficulty breathing, or widespread rash
- Signs of kidney problems, such as reduced urine output, swelling of the legs, or sudden weight gain
Medicines Containing this Salt
View AllDrug Warnings
- Keep all treatment appointments: Completing every treatment cycle on schedule helps achieve the best possible response. Do not skip or delay your appointments without consulting your doctor.
- Monitor your blood counts regularly: Blood tests before each treatment cycle help your doctor check your blood cell counts, kidney function, and liver function. Your dose may be delayed or adjusted depending on the results.
- Report signs of infection immediately: Contact your doctor if you develop a fever (38°C/100.4°F or higher), chills, persistent sore throat, cough, or any other signs of infection, as this medicine can lower your white blood cell count.
- Watch for unusual bleeding or bruising: Seek medical attention if you notice prolonged bleeding, frequent nosebleeds, blood in your urine or stools, or unusual bruising, as your platelet count may become low during treatment.
- Tell your healthcare provider before any surgery or dental procedure: This medicine may increase your risk of bleeding and infection, so your healthcare team should know you are receiving azacitidine.
- Avoid live vaccines during treatment: Live vaccines may increase your risk of infection while your immune system is weakened. Consult your doctor before receiving any vaccination.
- Pregnancy warning: Both men and women should use effective contraception during treatment and for the recommended period after the last dose because this medicine can harm an unborn baby. Do not breastfeed during treatment and for at least one week after your final dose.
- When to seek urgent medical care: Seek immediate medical attention if you develop severe shortness of breath, chest pain, swelling of the face or throat, severe allergic reactions, or yellowing of the skin or eyes.
Drug Interactions
- Other bone marrow-suppressing medicines: Combining Azacitidine with chemotherapy medicines or other drugs that reduce blood cell production may increase the risk of severe infections, anaemia, and bleeding.
- Immunosuppressants: Medicines that weaken the immune system, such as corticosteroids or certain medicines used after organ transplantation, may further increase your risk of infection.
- Anticoagulants and antiplatelet medicines: Medicines such as warfarin, apixaban, rivaroxaban, heparin, aspirin, or clopidogrel may increase the risk of bleeding, particularly if your platelet count becomes low during treatment.
- Live vaccines: Live vaccines should generally be avoided because your immune system may not respond safely while receiving this treatment.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is not known if alcohol affects Azacitidine. Please consult your doctor.
Pregnancy
unsafeAzacitidine belongs to pregnancy category D. Azacitidine should not be used during pregnancy as it may harm the baby. Consult the doctor immediately if you become pregnant during treatment with Azacitidine.
Breast Feeding
unsafeIt is unknown if Azacitidine passes into breast milk. Breastfeeding is not recommended during treatment with Azacitidine.
Driving
cautionAzacitidine may cause dizziness and tiredness. Avoid driving or operating machinery if you experience any side effects that might lessen your ability to do so.
Liver
cautionIf you have a history of liver disease, inform your doctor before receiving Azacitidine. This medicine should be used with caution in patients with severe pre-existing liver impairment.
Kidney
cautionIf you have a history of kidney disease, inform your doctor before receiving Azacitidine. Monitoring patients with kidney impairment is advised.
Children
unsafeAzacitidine is not recommended for children below 18 years as safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
The following lifestyle measures can help support your treatment and reduce the risk of complications while receiving Azacitidine:
- Reduce your risk of infections: Wash your hands frequently, avoid close contact with people who are sick, and wear a mask in crowded places if advised by your healthcare provider, as your immune system may be weakened during treatment.
- Choose safe, nutritious foods: Eat a balanced diet rich in protein, fruits, vegetables, and whole grains to support recovery. Wash fresh produce thoroughly and avoid raw or undercooked meat, seafood, eggs, and unpasteurised dairy products to reduce the risk of foodborne infections.
- Stay well-hydrated: Drink plenty of water and other healthy fluids unless your doctor has advised you to limit fluid intake. Good hydration helps support kidney function and your overall health during treatment.
- Prevent bleeding and injuries: Use a soft toothbrush, shave with an electric razor, and avoid activities that may cause cuts or bruises if your platelet count is low.
- Balance activity with rest: Light physical activity, such as walking, may help reduce fatigue, but listen to your body and get enough rest throughout your treatment.
- Attend all follow-up appointments: Regular blood tests and medical reviews are essential to monitor your blood counts, organ function, and response to treatment.
Special Advise
- Your doctor will recommend blood tests prior to treatment with Azacitidine and at the start of each cycle to check blood cell count, liver and kidney functioning.
- Women must use reliable contraception during treatment and for six months after receiving the last dose.
- Male patients are advised to use effective contraception during treatment and for three months after stopping the treatment.
- If you are due to undergo any surgery, including dental surgery, inform the doctor/dentist that you are on treatment with Azacitidine.
Patients Concern
Disease/Condition Glossary
Myelodysplastic syndromes: It is a group of cancers in which the immature blood cells in the bone marrow do not mature or become healthy blood cells. Signs and symptoms include shortness of breath, feeling tired or weak, pale skin, petechiae (flat, pinpoint spots under the skin caused by bleeding), and easy bleeding or bruising.
Chronic myelomonocytic leukaemia: It is a rare type of blood cancer in which there are too many monocytes (type of white blood cells) in the blood. Symptoms of chronic myelomonocytic leukaemia are tiredness, infections, bleeding or bruising easily, abdominal discomfort, weight loss, loss of appetite, sweating, skin rash, and bone and muscle pain.
Acute myeloid leukaemia: Acute myeloid leukaemia, also called acute myelogenous leukaemia or acute nonlymphocytic leukaemia, is the cancer of blood and bone marrow with excess immature white blood cells. Symptoms include fever, recurrent infections, fatigue, and easy bruising.
FAQs
Azacitidine is used to treat Myelodysplastic syndrome, chronic myelomonocytic leukaemia, and acute myeloid leukaemia.
Azacitidine works by preventing cancer cells from growing. Thereby, it helps treat cancer.
Men should avoid fathering a child whilst on treatment with Azacitidine. Consult the doctor if you wish to conserve your sperm before starting the treatment. Use effective contraception during the treatment with Azacitidine and for three months after stopping the treatment.
Azacitidine may cause a serious immune reaction known as differentiation syndrome. Consult the doctor immediately if you experience fever, rash, difficulty breathing, cough, decreased urine, rapid weight gain, low blood pressure, or swelling of the legs or arms.
No, Azacitidine is not a vesicant. It is a cytotoxic chemotherapy drug used to treat certain types of blood cancer, such as myelodysplastic syndrome (MDS). It is not known to cause severe tissue damage if it leaks from the injection site.
No, Azacitidine does not cause hair loss.
Yes, Azacitidine is a type of chemotherapy. It is used to treat certain types of blood cancers, such as myelodysplastic syndrome (MDS) and some forms of leukaemia.
Yes, Azacitidine is a cytotoxic drug. It works by interfering with the growth of cancer cells, which helps to slow down or stop their multiplication.
The common side effects of Azacitidine are nausea, vomiting, diarrhoea, constipation, weakness, headache, and injection site reactions. If any of these side effects persist or worsen, please consult your doctor.
Azacitidine is administered by a trained healthcare professional either as an injection under the skin (subcutaneous) or as an intravenous (IV) infusion. Your doctor will determine the most appropriate method based on your treatment plan.
This medicine can temporarily lower your red blood cells, white blood cells, and platelets. Regular blood tests help your doctor monitor your response to treatment, detect side effects early, and adjust your dose if necessary.
You should avoid live vaccines while receiving Azacitidine. Inactivated vaccines may be suitable in some cases, but always discuss vaccination plans with your doctor before receiving any vaccine.
Some people experience tiredness, weakness, or dizziness after treatment. If you notice these symptoms, avoid driving or operating machinery until you feel well again.
No. This medicine can harm an unborn baby and should not be used during pregnancy unless your doctor considers it absolutely necessary. Breastfeeding should be avoided during treatment and for at least one week after the last dose.
A fever may be an early sign of a serious infection because this medicine can lower your white blood cell count. Contact your healthcare provider immediately if your temperature reaches 38°C (100.4°F) or higher.
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