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prescription refrigerated

What is this medication?

VIDAZA (Azacitidine)
Antineoplastic Agent, Antimetabolite, DNA Methylation Inhibitor

VIDAZA (Azacitidine) is a nucleoside metabolic inhibitor indicated for the treatment of patients with the following FAB myelodysplastic syndrome (MDS) subtypes: Refractory anemia (RA) or refractory anemia with ringed sideroblasts (RARS) (if accompanied by neutropenia or thrombocytopenia or requiring transfusions), refractory anemia with excess blasts (RAEB), refractory anemia with excess blasts in transformation (RAEB-T), and chronic myelomonocytic leukemia (CMMoL).

How does this medication work? 

VIDAZA (Azacitidine) is a hypomethylating agent that is incorporated into DNA and RNA and inhibits DNA and RNA methyltransferases and subsequently reduces DNA and RNA methylation.  The reduction in methylation alters DNA gene expression (including re-expression of genes that regulate tumor suppression and cell differentiation).

How should I take this medication? 

IV/SQ: Inject 75 mg/m2/day for 7 days of a 28-day treatment cycle. Subsequent cycles of 75 mg/m2/day for 7 days every 4 weeks; dose may be increased to 100 mg/m2/day if no benefit is observed after 2 cycles and no toxicity other than nausea and vomiting have occurred. Patients should be treated for a minimum of 4 to 6 cycles; treatment may be continued as long as the patient continues to benefit.

Note: Azacitidine is associated with a moderate emetic; antiemetics are recommended to prevent nausea and vomiting. Do not substitute Azacitidine tablets for Azacitidine injection.

How to Take:
IV: Infuse over 10 to 40 minutes; intravenous infusion must be completed within 1 hour of (vial) reconstitution.

SQ: The manufacturer recommends equally dividing doses requiring more than one vial into 2 syringes and injecting subcutaneously into 2 separate sites. Rotate sites for each injection (thigh, abdomen, or upper arm). Administer subsequent injections at least 1 inch from previous injection sites; do not inject into tender, bruised, red, or hard areas. Allow refrigerated suspensions to come to room temperature (up to 30 minutes) prior to administration.

What should I watch for while using this medication? 

Before using VIDAZA (Azacitidine), make sure your physician is aware of any allergies or medications you currently take, pre-existing medical conditions and activities you perform. Azacitidine can cause bone marrow suppression which can lead to neutropenia, thrombocytopenia, and anemia.  A complete blood count (CBC) should be done prior to each treatment cycle and as needed to monitor response.   Azacitidine may cause hepatotoxicity in patients with pre-existing hepatic impairment. Azacitidine use is contraindicated in patients with advanced malignant hepatic tumors.  Azacitidine can also cause nephrotoxicity when combined with other chemotherapy agents. Monitoring liver enzymes and serum creatinine prior to and during each treatment cycle is recommended. 

What if I miss a dose?

If a dose is missed, take the dose as soon as possible on the same day. Resume the normal schedule the following day. Do not take 2 doses on the same day.

How should I store this medication?

Store unreconstituted vials at 25ºC (77ºF); excursions permitted to 15º to 30ºC (59º to 86ºF). After removal from refrigerated conditions, the suspension may be allowed to equilibrate to room temperature for up to 30 minutes prior to administration.

What are the possible side effects of using this medication?

Chest pain, ecchymoses, erythema of skin, pruritus, skin rash, abdominal pain, abdominal tenderness, anorexia, constipation, decreased appetite, diarrhea, nausea, vomiting, anemia, febrile neutropenia, leukopenia, neutropenia, petechiae, thrombocytopenia, anxiety, dizziness, fatigue, headache, insomnia, malaise, arthralgia, asthenia, limb pain, myalgia, dyspnea, nasopharyngitis, pneumonia, upper respiratory infection, fever.

Note this is not a complete list of side effects for VIDAZA (Azacitidine), only common ones.