Azacitidine | Side Effects, Dosage, Uses & More
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Generic Name:

azacitidine, Injectable Suspension

All Brands

  • Vidaza
SECTION 1 of 5

Highlights for azacitidine

Injectable Suspension
1

Azacitidine is used to treat myelodysplastic syndrome (MDS). This is a type of bone marrow cancer.

2

This drug comes in the form of an injectable solution that’s given intravenously (into your vein). It also comes as a suspension that’s given subcutaneously (under your skin). This drug is only given by a healthcare provider who has experience with chemotherapy medications. You won’t give it to yourself.

3

Azacitidine is available as a brand-name drug called Vidaza. It’s also available as a generic drug.

4

The more common side effects of this drug include nausea, vomiting, diarrhea, constipation, fever, and weakness. They also include low red and white blood cell and platelet counts, and low potassium levels in your blood.

5

In some cases, azacitidine can cause serious side effects. These include very low red and white blood cell counts, very low platelet counts, liver and kidney damage, and heart problems.

IMPORTANT INFORMATION

Low blood cell counts

This drug may decrease your red and white blood cells and your platelets. Red blood cells carry oxygen. White blood cells fight infection. Platelets help blood clotting. Your doctor will check your blood counts before starting and during treatment with this drug.

Serious infections

This drug may cause serious infections. It can lower the ability of your immune system to fight infections. Call your doctor right away if you have any signs of an infection. These include a runny nose or sore throat that don’t go away (cold symptoms), a cough, tiredness, and body aches (flu symptoms), or a fever. Symptoms may also include cuts or scrapes that are red, warm, swollen, or painful.

Harm to an unborn baby

This drug may harm an unborn baby. Women shouldn’t take this drug if they’re pregnant or plan to become pregnant. Men shouldn’t get their partner pregnant while they’re receiving this medication.

Drug features

This drug is a prescription drug. It’s available as a powder that’s mixed with sterile water for injection. It’s given as a solution intravenously (into your vein) or as a suspension subcutaneously (under your skin). This drug is only given by a healthcare provider. You won’t give it to yourself.

Azacitidine is available as a brand-name drug called Vidaza. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it's used

This drug is used to treat myelodysplastic syndrome (MDS).

More Details

How it works

This drug belongs to a class of cancer drugs called DNA hypomethylating agents.

More Details

Why it's used

This drug is used to treat myelodysplastic syndrome (MDS). This is a type of bone marrow cancer. It’s used to treat the following subtypes:

  • refractory anemia or refractory anemia with ringed sideroblasts
  • refractory anemia with excess blasts
  • refractory anemia with excess blasts in transformation
  • chronic myelomonocytic leukemia

Bone marrow is the spongy material inside your bones. It makes three kinds of blood cells: red blood cells, white blood cells, and platelets.

In MDS, cells in your bone marrow are damaged and have trouble making new blood cells. Often the blood cells made by the damaged bone marrow cells aren’t normal and don’t work well. These abnormal blood cells die sooner than normal blood cells. This causes low blood cell counts. This can cause infections, anemia, or abnormal bleeding and easy bruising.

How it works

This drug belongs to a class of cancer drugs called DNA hypomethylating agents. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug also belongs to a category of chemotherapy drugs called antimetabolites.

This drug works to fight cancer in two different ways:

  • Cells contain a substance called deoxyribonucleic acid (DNA). DNA stores information that tells cells how to work. This information is passed on to the next generation of life by the cells. This drug works by taking chemical groups away from the DNA of cancer cells. This suppresses the cancer cells and lets the healthy cells become active again.
  • Antimetabolites are similar to normal substances within cells. When this drug makes its way into cancer cells, it produces a toxic effect. This causes the cancer cells to die.
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azacitidine Side Effects

Injectable Suspension

More Common Side Effects

The more common side effects for this drug given intravenously are slightly different from the side effects for this drug given subcutaneously.

  • Side effects for intravenous infusion and subcutaneous injection can include:

    • anemia (low red blood cell counts). Symptoms may include:
      • extreme fatigue
      • pale-colored skin
      • weakness
      • shortness of breath
      • dizziness or lightheadedness
      • cold hands and feet
    • thrombocytopenia (low platelet counts). Symptoms may include:
      • bruising more or easier than normal
      • bleeding into your skin. This may show up as a rash of pinpoint-sized reddish-purple spots.
      • bleeding longer than normal from cuts
      • bleeding from your gums or nose
      • blood in your urine or stools
      • unusually heavy menstrual periods
      • tiredness
    • leukopenia (low white blood cell counts) and neutropenia (low neutrophil counts). Neutrophils are a type of white blood cell that helps fight off infections. Symptoms may include:
      • infections
      • fever
    • diarrhea
    • nausea
    • vomiting
    • fever
    • constipation
    • redness or bruising at the site of your skin where you received the injection
  • Side effects for intravenous infusion can include the above, plus:

    • small reddish-purple spots on your body
    • chills
    • weakness
    • hypokalemia (low potassium in the blood)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Liver problems. Symptoms may include:

    • nausea
    • vomiting
    • stomach pain and swelling
    • swelling in your legs and ankles
    • bruising more easily than normal
    • pale-colored stool
    • unusual or unexplained tiredness
    • loss of appetite
    • dark-colored urine
    • yellowing of your skin or the whites of your eyes
  • Kidney problems. Symptoms may include:

    • swelling of your feet, ankles, or legs
    • drowsiness
    • tiredness
    • chest pain
    • nausea
    • shortness of breath
    • making less urine than normal
  • Heart problems. These include heart failure, high blood pressure, low blood pressure, and arrhythmias (irregular heart rate). Symptoms may include:

    • shortness of breath
    • swelling of your arms or legs
    • tiredness
    • fast or irregular heartbeat
    • sudden weight gain from fluid retention
  • Blood disorders. Symptoms may include:

    • anemia (low red blood cell counts). Symptoms may include:
      • extreme fatigue
      • pale-colored skin
      • weakness
      • shortness of breath
      • dizziness or lightheadedness
      • cold hands and feet
    • thrombocytopenia (low platelet counts). Symptoms may include:
      • bruising more or easier than normal
      • bleeding into your skin. This may show up as a rash of pinpoint-sized reddish-purple spots.
      • bleeding longer than normal from cuts
      • bleeding from your gums or nose
      • blood in your urine or stools
      • unusually heavy menstrual periods
      • tiredness
    • leukopenia (low white blood cell counts) and neutropenia (neutrophil counts). Symptoms may include:
      • infections
      • fever
  • Low potassium levels in your blood. Symptoms may include:

    • weakness
    • fatigue
    • muscle cramps
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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azacitidine May Interact with Other Medications

Injectable Suspension

Azacitidine can interact with other medications, herbs or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs, or vitamins you’re taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body. This can cause more side effects. This medication may also make your kidney disease worse.

People with liver problems

People with advanced cancerous liver tumors shouldn’t use this drug. If you have other liver problems, ask your doctor whether this drug is safe for you. This drug may cause more liver damage if you have liver disease.

Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

Men shouldn’t get their partner pregnant while receiving this drug.

Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may adjust your dose of this drug and watch your kidney function closely.

For children

This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

When to call the doctor

Call your doctor right away if you become pregnant or get someone pregnant while taking this drug.

Allergies

This drug can cause a severe allergic reaction. Mannitol, an ingredient in this drug, can also cause an allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or mannitol. Taking it again could be fatal (cause death).

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How to Take azacitidine (Dosage)

Injectable Suspension

Your doctor will determine a dosage that’s right for you based on your individual needs. Your general health may affect your dosage. Tell your doctor about all health conditions you have before your healthcare provider administers the drug to you.

Your doctor will decide your dose based on your body surface area (BSA).

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This comes with risks if you don’t take it as prescribed.

If you miss doses or don’t take the drug on schedule

If you miss doses, your medication may not work as well or may stop working completely. Your symptoms may also return. You may have fatigue, shortness of breath, unusual paleness, infection, anemia, abnormal bleeding, or easy bruising.

What to do if you miss a dose

If you miss an appointment to receive this drug, call your healthcare provider right away. It’s very important to receive this drug as directed by your doctor so it can work to treat your condition.

How to tell if the drug is working

Your myelodysplastic syndrome (MDS) will be treated and your cancer may go into remission. Your doctor will do blood work to tell if this drug is working for you. If your MDS causes symptoms, they should improve if this drug is working.

This drug is used for long-term treatment.

This drug is given in 28-day cycles

You’ll receive it once per day for 7 days in a row. Then you won’t receive it for the next 21 days.

Your doctor will look at your blood counts and other factors during your treatment with this drug. If your doctor decides it’s necessary, you may have another 28-day treatment cycle with this drug. It may take several cycles (about 4–6 months) for your doctor to notice a difference in your blood cell counts.

How long does it take?

It will take about 10–40 minutes to receive this drug intravenously (into your vein). It will take 1 minute to receive it as a subcutaneous injection (under your skin).

Can I drive home after?

This drug may make you feel dizzy or tired. You may need someone to drive you home after your receive it.

You shouldn’t drive or use machinery while you’re on this medication until you know how it affects you.

Travel

This medication should only be given by a healthcare provider who knows your medical history. It should also only be given at a location with appropriate medical support.

This drug is given in 28-day cycles. You’ll receive it once per day for 7 days in a row. Then you won’t receive it for the next 21 days. You may have several cycles.

Tell your doctor if you plan on traveling while you’re receiving this medication.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. Your doctor will also check if this drug is working to treat your condition. These issues include:

  • Blood cell counts. This drug may decrease your white and red blood cells and your platelets. Your doctor will check your blood counts before starting and during treatment with this drug.
  • Infections. This drug can lower the ability of your immune system to fight infections. You and your doctor should watch for signs of infections. Your doctor may do tests such as a complete blood count (CBC) and check your temperature.
  • Kidney function. This drug may cause kidney problems. These include kidney failure and renal tubular acidosis. Your healthcare provider will do tests to check how well your kidneys are working. These include a creatinine clearance (CrCl), blood urea nitrogen (BUN), and serum bicarbonate test.
  • Liver function. This drug can cause liver damage, especially if you already have liver disease. Your doctor will do tests to check how this drug is affecting your liver.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

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How Much Does azacitidine Cost?

Injectable Suspension

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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