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Dacarbazine: Drug information

Dacarbazine: Drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Dacarbazine: Patient drug information" and "Dacarbazine: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Experienced physician:

It is recommended that dacarbazine be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents.

In treatment of each patient, the physician must weigh carefully the possibility of achieving therapeutic benefit against the risk of toxicity.

Bone marrow suppression:

Hemopoietic depression is the most common toxicity with dacarbazine.

Hepatic effects:

Hepatic necrosis has been reported.

Carcinogenic/teratogenic:

Studies have demonstrated this agent to have a carcinogenic and teratogenic effect when used in animals.

Pharmacologic Category
  • Antineoplastic Agent, Alkylating Agent (Triazene)
Dosing: Adult

Dosage guidance:

Clinical considerations: Dacarbazine is associated with a high emetic potential; antiemetics are recommended to prevent nausea and vomiting (Ref). Refer to the protocol or institutional guidance for additional details of off-label dosing.

Hodgkin lymphoma

Hodgkin lymphoma:

ABVD regimen: IV: 375 mg/m2 on days 1 and 15 every 4 weeks (in combination with doxorubicin, bleomycin, and vinblastine) for 2 to 4 cycles (Ref). The number of cycles required and follow-up treatment may be determined by PET scan after 2 cycles (Ref).

A-AVD regimen: IV: 375 mg/m2 on days 1 and 15 every 4 weeks (in combination with brentuximab vedotin, doxorubicin, and vinblastine) for up to 6 cycles (Ref). Administer primary prophylaxis with G-CSF (filgrastim) beginning with cycle 1.

Melanoma, metastatic malignant

Melanoma, metastatic malignant: IV: 250 mg/m2 over 30 minutes once daily on days 1 to 5 every 3 weeks for up to 12 cycles or until disease progression or unacceptable toxicity (Ref) or 850 to 1,000 mg/m2 once every 3 weeks until disease progression or unacceptable toxicity (Ref).

Pancreatic neuroendocrine tumors, advanced

Pancreatic neuroendocrine tumors, advanced (off-label use): IV: 850 mg/m2 over 60 to 90 minutes on day 1 every 4 weeks until disease progression or unacceptable toxicity (minimum of 2 cycles) (Ref).

Pheochromocytoma, malignant

Pheochromocytoma, malignant (off-label use): CVD regimen: IV: 600 mg/m2 once daily for 2 days every 3 or 4 weeks (in combination with cyclophosphamide and vincristine) until disease progression or unacceptable toxicity (Ref).

Soft tissue sarcoma, advanced

Soft tissue sarcoma, advanced (off-label use):

Single agent therapy: IV: 1,200 mg/m2 once every 3 weeks for up to 8 cycles (Ref).

Combination therapy:

AD regimen: IV: 250 mg/m2/day as a continuous infusion for 4 days every 3 weeks (total of 1,000 mg/m2/cycle) (in combination with doxorubicin); patients received a median of 3 cycles (Ref) or 187.5 mg/m2/day as a continuous infusion for 4 days every 3 weeks (total of 750 mg/m2/cycle) (in combination with doxorubicin) until disease progression or unacceptable toxicity (Ref).

MAID regimen: IV: 250 mg/m2/day as a continuous infusion for 4 days every 3 weeks (total of 1,000 mg/m2/cycle) (in combination with mesna, doxorubicin, and ifosfamide) (Ref). Continue until disease progression or unacceptable toxicity (Ref).

Gemcitabine/Dacarbazine regimen: IV: 500 mg/m2 once every 2 weeks (in combination with gemcitabine) for up to 12 cycles (Ref).

Thyroid carcinoma, medullary, advanced or metastatic

Thyroid carcinoma, medullary, advanced or metastatic (off-label use): IV: 200 mg/m2 once daily for 5 days every 8 weeks (in combination with fluorouracil and alternating with doxorubicin/streptozocin) until disease progression or unacceptable toxicity, or for a total of 6 cycles if tumor response or stabilization (Ref) or 200 mg/m2 once daily for 5 days every 6 weeks (in combination with fluorouracil and alternating with streptozocin/fluorouracil) until disease progression or unacceptable toxicity (Ref) or 600 mg/m2 once daily for 2 days every 3 or 4 weeks (in combination with cyclophosphamide and vincristine); patients received a median of 4 cycles (range: 2 to 17 cycles) (Ref) or 250 mg/m2 over 15 to 30 minutes once daily for 5 days every 4 weeks (in combination with fluorouracil) until disease progression or for a maximum of 6 cycles (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling. The following adjustments have been recommended:

Kintzel 1995:

CrCl 46 to 60 mL/minute: Reduce dose to 80% of usual dose.

CrCl 31 to 45 mL/minute: Reduce dose to 75% of usual dose.

CrCl ≤30 mL/minute: Reduce dose to 70% of usual dose.

Krens 2019:

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Consider reducing dose to 70% of usual dose.

Hemodialysis: Consider reducing dose to 70% of usual dose.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling. May cause hepatotoxicity; monitor closely for signs of toxicity.

The following adjustments have been recommended (Ref):

Mild to moderate impairment: No dosage adjustment necessary.

Severe impairment: Use is not recommended.

Dosing: Obesity: Adult

American Society of Clinical Oncology guidelines for appropriate systemic therapy dosing in adults with cancer with a BMI ≥30 kg/m2: Utilize patient's actual body weight for calculation of BSA- or weight-based dosing; manage regimen-related toxicities in the same manner as for patients with a BMI <30 kg/m2; if a dose reduction is utilized due to toxicity, may consider resumption of full weight-based dosing (or previously tolerated dose level) with subsequent cycles only if dose escalations are allowed in the prescribing information, if contributing underlying factors (eg, hepatic or kidney impairment) are sufficiently resolved, AND if performance status has markedly improved or is considered adequate (Ref).

Dosing: Adjustment for Toxicity: Adult

Hematologic toxicity: May require temporary dacarbazine treatment interruption or discontinuation.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Dacarbazine: Pediatric drug information")

Dosage guidance:

Clinical considerations: For oncology uses, details concerning dosing in combination regimens should also be consulted. Dacarbazine in combination with doxorubicin is associated with a high emetic potential; antiemetics are recommended to prevent nausea and vomiting (Ref).

Hodgkin lymphoma

Hodgkin lymphoma: Limited data available:

High risk:

ABVD regimen: Children and Adolescents: IV: 375 mg/m2 over 30 to 60 minutes on Days 1 and 15 of a 28-day treatment cycle for 2 to 6 cycles in combination with doxorubicin, vinblastine, and bleomycin (Ref).

CAPDac consolidation regimen: Children ≥6 years and Adolescents: IV: 250 mg/m2 on Days 1 to 3 of a 21-day treatment cycle for 4 cycles in combination with cyclophosphamide, brentuximab vedotin, and prednisone (Ref).

Intermediate or advanced stage:

Bv-AVD-R regimen: Children ≥4 years and Adolescents: IV: 375 mg/m2 on Days 1 and 15 of a 28-day treatment cycle for 4 to 6 cycles in combination with brentuximab vedotin, doxorubicin, vinblastine, and rituximab (Ref).

COPDac consolidation regimen: Children and Adolescents: IV: 250 mg/m2 on Days 1 to 3 of a 28-day treatment cycle for 2 to 4 cycles in combination with prednisone/prednisolone, vincristine, and cyclophosphamide (Ref).

Melanoma, high risk

Melanoma, high risk: Limited data available: Children ≥10 years and Adolescents: IV: 800 mg/m2 over 1 hour on Day 1 of a 21-day treatment cycle for 3 cycles; in combination with vinblastine, cisplatin, and interferon alfa-2b. Note: Administer dacarbazine after vinblastine on Day 1 (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; experience in adult patients suggests dose adjustment may be necessary; use with caution.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling. May cause hepatotoxicity; monitor closely for signs of toxicity.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not always defined.

Central nervous system: Infusion-site pain

Dermatologic: Alopecia

Gastrointestinal: Nausea and vomiting (>90%), anorexia

Hematologic & oncologic: Bone marrow depression (onset: 5 to 7 days; nadir: 7 to 10 days; recovery: 21 to 28 days), leukopenia, thrombocytopenia

<1%, postmarketing, and/or case reports: Anaphylaxis, anemia, diarrhea, dysgeusia, eosinophilia, erythema, facial flushing, facial paresthesia, flu-like symptoms (fever, myalgia, malaise), hepatic necrosis, increased liver enzymes (transient), paresthesia, renal function test abnormality, skin photosensitivity, skin rash, urticaria, venous obstruction (hepatic vein)

Contraindications

Hypersensitivity to dacarbazine or any component of the formulation.

Canadian labeling: Additional contraindications (not in the US labeling): Prior severe myelosuppression.

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylaxis: May occur following dacarbazine administration.

• Bone marrow suppression: Hematologic toxicity is the most common dacarbazine toxicity. Leukopenia and thrombocytopenia may be severe; anemia may also occur. The onset for leukopenia is ~14 days (range: 10 to 30 days) and the duration is ~1 to 3 weeks. The onset for thrombocytopenia is ~18 days (range: 12 to 30 days) and the duration is ~1 to 3 weeks.

• Extravasation: Dacarbazine is an irritant; local reactions may occur (ESMO/EONS [Pérez Fidalgo 2012]). According to the manufacturer, extravasation may result in tissue damage and severe pain.

• Hepatotoxicity: Hepatic necrosis has been reported with dacarbazine. Hepatotoxicity may be accompanied with hepatic vein thrombosis and hepatocellular necrosis; may be fatal. Hepatotoxicity usually occurs with combination chemotherapy, but may occur with dacarbazine alone.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Intravenous:

Generic: 100 mg (1 ea); 200 mg (1 ea)

Solution Reconstituted, Intravenous [preservative free]:

Generic: 200 mg (1 ea)

Generic Equivalent Available: US

Yes

Pricing: US

Solution (reconstituted) (Dacarbazine Intravenous)

100 mg (per each): $14.87

200 mg (per each): $12.00 - $14.40

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Intravenous:

Generic: 600 mg (1 ea)

Administration: Adult

Dacarbazine is associated with a high emetic potential; antiemetics are recommended to prevent nausea and vomiting (Ref).

IV: Infuse over 15 to 60 minutes; rapid infusion may cause severe venous irritation. Other infusion durations have been reported; refer to literature and/or regimen for infusion details (may vary by protocol).

Dacarbazine is an irritant; local reactions may occur (Ref). Monitor infusion site.

Administration: Pediatric

Note: Dacarbazine in combination with doxorubicin is associated with a high emetic potential; antiemetics are recommended to prevent nausea and vomiting (Ref).

Parenteral: Administer by IV infusion over 15 to 60 minutes; rapid infusion may cause severe venous irritation. Dacarbazine is an irritant; local reactions may occur (Ref). Monitor infusion site.

Hazardous Drugs Handling Considerations

Hazardous agent (NIOSH 2024 [table 1]).

Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2023; NIOSH 2024; USP-NF 2020).

Use: Labeled Indications

Hodgkin lymphoma: Treatment of Hodgkin lymphoma (in combination with other chemotherapy agents).

Melanoma, metastatic malignant: Treatment of metastatic malignant melanoma.

Use: Off-Label: Adult

Pancreatic neuroendocrine tumors, advanced; Pheochromocytoma, malignant; Soft-tissue sarcomas, advanced or metastatic; Thyroid carcinoma, medullary, advanced or metastatic

Medication Safety Issues
Sound-alike/look-alike issues:

Dacarbazine may be confused with dactinomycin, procarbazine

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drug classes (chemotherapeutic agent, parenteral and oral) which have a heightened risk of causing significant patient harm when used in error (High-Alert Medications in Acute Care, Community/Ambulatory Care, and Long-Term Care Settings).

Metabolism/Transport Effects

Substrate of CYP1A2 (Minor), CYP2E1 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

5-Aminosalicylic Acid Derivatives: May increase myelosuppressive effects of Myelosuppressive Agents. Risk C: Monitor

Abrocitinib: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Antithymocyte Globulin (Equine): Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Antithymocyte Globulin (Equine). Specifically, these effects may be unmasked if the dose of cytotoxic chemotherapy is reduced. Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Antithymocyte Globulin (Equine). Specifically, infections may occur with greater severity and/or atypical presentations. Risk C: Monitor

Antithyroid Agents: Myelosuppressive Agents may increase neutropenic effects of Antithyroid Agents. Risk C: Monitor

Baricitinib: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Baricitinib. Risk X: Avoid

BCG Products: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of BCG Products. Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of BCG Products. Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Brincidofovir: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Brincidofovir. Risk C: Monitor

Brivudine: May increase adverse/toxic effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Chikungunya Vaccine (Live): Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Chikungunya Vaccine (Live). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Chikungunya Vaccine (Live). Risk X: Avoid

Chloramphenicol (Ophthalmic): May increase adverse/toxic effects of Myelosuppressive Agents. Risk C: Monitor

Chloramphenicol (Systemic): Myelosuppressive Agents may increase myelosuppressive effects of Chloramphenicol (Systemic). Risk X: Avoid

Cladribine: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Cladribine. Risk X: Avoid

CloZAPine: Myelosuppressive Agents may increase adverse/toxic effects of CloZAPine. Specifically, the risk for neutropenia may be increased. Risk C: Monitor

Coccidioides immitis Skin Test: Coadministration of Immunosuppressants (Cytotoxic Chemotherapy) and Coccidioides immitis Skin Test may alter diagnostic results. Management: Consider discontinuing cytotoxic chemotherapy several weeks prior to coccidioides immitis skin antigen testing to increase the likelihood of accurate diagnostic results. Risk D: Consider Therapy Modification

COVID-19 Vaccine (Inactivated Virus): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of COVID-19 Vaccine (Inactivated Virus). Risk C: Monitor

COVID-19 Vaccine (mRNA): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of COVID-19 Vaccine (mRNA). Management: Give a 3-dose primary series for all patients aged 6 months and older taking immunosuppressive medications or therapies. Booster doses are recommended for certain age groups. See CDC guidance for details. Risk D: Consider Therapy Modification

COVID-19 Vaccine (Subunit): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of COVID-19 Vaccine (Subunit). Risk C: Monitor

Deferiprone: Myelosuppressive Agents may increase neutropenic effects of Deferiprone. Management: Avoid the concomitant use of deferiprone and myelosuppressive agents whenever possible. If this combination cannot be avoided, monitor the absolute neutrophil count more closely. Risk D: Consider Therapy Modification

Dengue Tetravalent Vaccine (Live): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Dengue Tetravalent Vaccine (Live). Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Dengue Tetravalent Vaccine (Live). Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Denosumab: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Management: Consider the risk of serious infections versus the potential benefits of coadministration of denosumab and cytotoxic chemotherapy. If combined, monitor patients for signs/symptoms of serious infections. Risk D: Consider Therapy Modification

Deucravacitinib: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Etrasimod: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Fexinidazole: Myelosuppressive Agents may increase myelosuppressive effects of Fexinidazole. Risk X: Avoid

Filgotinib: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Fotemustine: May increase adverse/toxic effects of Dacarbazine. Specifically, the risk for pulmonary toxicity (adult acute respiratory distress syndrome) may be increased. Management: Do not administer fotemustine and dacarbazine simultaneously, particularly with high doses of dacarbazine. An interval of 1 week should be left between the last dose of fotemustine and the first dose of dacarbazine. Risk D: Consider Therapy Modification

Inebilizumab: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Inebilizumab. Risk C: Monitor

Influenza Virus Vaccines: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Influenza Virus Vaccines. Management: Administer influenza vaccines at least 2 weeks prior to initiating chemotherapy if possible. If vaccination occurs less than 2 weeks prior to or during chemotherapy, revaccinate at least 3 months after therapy discontinued if immune competence restored. Risk D: Consider Therapy Modification

Leflunomide: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Leflunomide. Management: Increase the frequency of chronic monitoring of platelet, white blood cell count, and hemoglobin or hematocrit to monthly, instead of every 6 to 8 weeks, if leflunomide is coadministered with immunosuppressive agents, such as cytotoxic chemotherapy. Risk D: Consider Therapy Modification

Lenograstim: Antineoplastic Agents may decrease therapeutic effects of Lenograstim. Management: Avoid the use of lenograstim 24 hours before until 24 hours after the completion of myelosuppressive cytotoxic chemotherapy. Risk D: Consider Therapy Modification

Linezolid: May increase myelosuppressive effects of Myelosuppressive Agents. Risk C: Monitor

Lipegfilgrastim: Antineoplastic Agents may decrease therapeutic effects of Lipegfilgrastim. Management: Avoid concomitant use of lipegfilgrastim and myelosuppressive cytotoxic chemotherapy. Lipegfilgrastim should be administered at least 24 hours after the completion of myelosuppressive cytotoxic chemotherapy. Risk D: Consider Therapy Modification

Mumps- Rubella- or Varicella-Containing Live Vaccines: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Mumps- Rubella- or Varicella-Containing Live Vaccines. Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Mumps- Rubella- or Varicella-Containing Live Vaccines. Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Nadofaragene Firadenovec: Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Nadofaragene Firadenovec. Specifically, the risk of disseminated adenovirus infection may be increased. Risk X: Avoid

Natalizumab: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Natalizumab. Risk X: Avoid

Ocrelizumab: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Ocrelizumab. Risk C: Monitor

Ofatumumab: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Ofatumumab. Risk C: Monitor

Olaparib: Myelosuppressive Agents may increase myelosuppressive effects of Olaparib. Risk C: Monitor

Palifermin: May increase adverse/toxic effects of Antineoplastic Agents. Specifically, the duration and severity of oral mucositis may be increased. Management: Do not administer palifermin within 24 hours before, during infusion of, or within 24 hours after administration of myelotoxic chemotherapy. Risk D: Consider Therapy Modification

Pidotimod: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Pidotimod. Risk C: Monitor

Pimecrolimus: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Piperacillin: May increase hypokalemic effects of Antineoplastic Agents. Risk C: Monitor

Pneumococcal Vaccines: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Pneumococcal Vaccines. Risk C: Monitor

Poliovirus Vaccine (Live/Trivalent/Oral): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Poliovirus Vaccine (Live/Trivalent/Oral). Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Poliovirus Vaccine (Live/Trivalent/Oral). Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Polymethylmethacrylate: Immunosuppressants (Cytotoxic Chemotherapy) may increase hypersensitivity effects of Polymethylmethacrylate. Management: Use caution when considering use of bovine collagen-containing implants such as the polymethylmethacrylate-based Bellafill brand implant in patients who are receiving immunosuppressants. Consider use of additional skin tests prior to administration. Risk D: Consider Therapy Modification

Promazine: May increase myelosuppressive effects of Myelosuppressive Agents. Risk C: Monitor

Rabies Vaccine: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider Therapy Modification

Ritlecitinib: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Ritlecitinib. Risk X: Avoid

Ropeginterferon Alfa-2b: Myelosuppressive Agents may increase myelosuppressive effects of Ropeginterferon Alfa-2b. Management: Avoid coadministration of ropeginterferon alfa-2b and other myelosuppressive agents. If this combination cannot be avoided, monitor patients for excessive myelosuppressive effects. Risk D: Consider Therapy Modification

Ruxolitinib (Topical): Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Ruxolitinib (Topical). Risk X: Avoid

Sipuleucel-T: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Sipuleucel-T. Management: Consider reducing the dose or discontinuing the use of immunosuppressants, such as cytotoxic chemotherapy, prior to initiating sipuleucel-T therapy. Risk D: Consider Therapy Modification

SORAfenib: May increase adverse/toxic effects of Dacarbazine. SORAfenib may increase active metabolite exposure of Dacarbazine. Risk C: Monitor

Sphingosine 1-Phosphate (S1P) Receptor Modulators: May increase immunosuppressive effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk C: Monitor

Tacrolimus (Topical): Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Tacrolimus (Topical). Risk X: Avoid

Talimogene Laherparepvec: Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Talimogene Laherparepvec. Specifically, the risk of infection from the live, attenuated herpes simplex virus contained in talimogene laherparepvec may be increased. Risk X: Avoid

Tertomotide: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Tertomotide. Risk X: Avoid

Tofacitinib: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Tofacitinib. Risk X: Avoid

Typhoid Vaccine: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Typhoid Vaccine. Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Typhoid Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Ublituximab: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Ublituximab. Risk C: Monitor

Upadacitinib: Immunosuppressants (Cytotoxic Chemotherapy) may increase immunosuppressive effects of Upadacitinib. Risk X: Avoid

Vaccines (Live): Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Vaccines (Live). Specifically, the risk of vaccine-associated infection may be increased. Vaccines (Live) may decrease therapeutic effects of Immunosuppressants (Cytotoxic Chemotherapy). Risk X: Avoid

Vaccines (Non-Live/Inactivated/Non-Replicating): Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Vaccines (Non-Live/Inactivated/Non-Replicating). Management: Give non-live/inactivated/non-replicating vaccines at least 2 weeks prior to starting chemotherapy when possible. Patients vaccinated less than 14 days before or during chemotherapy should be revaccinated at least 3 months after therapy is complete. Risk D: Consider Therapy Modification

Yellow Fever Vaccine: Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Yellow Fever Vaccine. Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Yellow Fever Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Risk X: Avoid

Zoster Vaccine (Live/Attenuated): Immunosuppressants (Cytotoxic Chemotherapy) may increase adverse/toxic effects of Zoster Vaccine (Live/Attenuated). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Cytotoxic Chemotherapy) may decrease therapeutic effects of Zoster Vaccine (Live/Attenuated). Risk X: Avoid

Reproductive Considerations

Dacarbazine is a component of the ABVD regimen used for the treatment of Hodgkin lymphoma; there may be a low risk of amenorrhea and an intermediate risk of azoospermia associated with therapy. Fertility preservation can be discussed prior to therapy (ESMO [Lambertini 2020]; Traila 2018).

Pregnancy Considerations

Teratogenic effects were observed in animal reproduction studies. Outcome data following maternal use of dacarbazine primarily as part of a regimen for the treatment of Hodgkin lymphoma during pregnancy is available (Avilés 2018; Cotteret 2020; Evens 2013; NTP 2013; Pinnix 2016).

Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of dacarbazine may be altered (Kantrowitz-Gordon 2018).

The European Society for Medical Oncology has published guidelines for diagnosis, treatment, and follow-up of cancer during pregnancy. The guidelines recommend referral to a facility with expertise in cancer during pregnancy and encourage a multidisciplinary team (obstetrician, neonatologist, oncology team). In general, if chemotherapy is indicated, it should be avoided during in the first trimester, there should be a 3-week time period between the last chemotherapy dose and anticipated delivery, and chemotherapy should not be administered beyond week 33 of gestation (ESMO [Peccatori 2013]). An international consensus panel has published guidelines for hematologic malignancies during pregnancy. Dacarbazine is a component of the ABVD regimen, which is used for the treatment of Hodgkin lymphoma. If treatment cannot be deferred until after delivery in patients with early stage Hodgkin lymphoma, ABVD may be administered safely and effectively in the latter phase of pregnancy (based on limited data); for patients with advanced-stage disease, ABVD can be administered in the second and third trimesters (Lishner 2016).

A long-term observational research study is collecting information about the diagnosis and treatment of cancer during pregnancy. For additional information about the pregnancy and cancer registry or to become a participant, contact Cooper Health (1-877-635-4499).

Breastfeeding Considerations

It is not known if dacarbazine is present in breast milk.

Due to the potential for serious adverse reactions in the breastfed infant, a decision should be made to discontinue dacarbazine or to discontinue breastfeeding, taking into account the benefits of treatment to the mother.

Monitoring Parameters

CBC with differential, liver function, renal function. Monitor closely for signs of toxicity in patients with hepatic or kidney dysfunction. Monitor infusion site.

The American Society of Clinical Oncology hepatitis B virus (HBV) screening and management provisional clinical opinion (ASCO [Hwang 2020]) recommends HBV screening with hepatitis B surface antigen, hepatitis B core antibody, total Ig or IgG, and antibody to hepatitis B surface antigen prior to beginning (or at the beginning of) systemic anticancer therapy; do not delay treatment for screening/results. Detection of chronic or past HBV infection requires a risk assessment to determine antiviral prophylaxis requirements, monitoring, and follow-up.

Mechanism of Action

Dacarbazine is an alkylating agent which is converted to the active alkylating metabolite MTIC [(methyl-triazene-1-yl)-imidazole-4-carboxamide] via the cytochrome P450 system. The cytotoxic effects of MTIC are manifested through alkylation (methylation) of DNA at the O6, N7 guanine positions which lead to DNA double strand breaks and apoptosis. Dacarbazine is non-cell cycle specific (Marchesi 2007).

Pharmacokinetics (Adult Data Unless Noted)

Distribution: Exceeds total body water; suggesting binding to some tissue (probably liver) (Perry 2012)

Metabolism: Extensively hepatic to the active metabolite MTIC [(methyl-triazene-1-yl)-imidazole-4-carboxamide]

Half-life elimination: Biphasic: Initial: 19 minutes, 55 minutes (renal and hepatic dysfunction); Terminal: 5 hours, 7.2 hours (renal and hepatic dysfunction)

Excretion: Urine (~40%; as unchanged drug)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Dacarbazina Filaxis | Dacarbazina varifarma | Oncocarbil;
  • (AT) Austria: Dacarbazin lipomed | Dacarbazin Medac | Dtic-dome;
  • (AU) Australia: Dacarbazine Sandoz;
  • (BE) Belgium: Dtic;
  • (BG) Bulgaria: Dacarbazin | Dacarbazin lipomed;
  • (BR) Brazil: D.t.i. | Dacarb | Dacarbazina | Fauldacar;
  • (CL) Chile: Dacarbazina | Dacarbazina kampar | Deticene;
  • (CO) Colombia: Al quibazina | Carbaven | Dacarbazina | Dacarbazine medac | Daracina | Deticene | Tiferomed;
  • (CZ) Czech Republic: Dacarbazin | Dacarbazine medac | Dtic;
  • (DE) Germany: Dacarbazin lipomed | Detimedac | Dtic;
  • (EC) Ecuador: Dacarbazina | Deticene;
  • (EE) Estonia: Dacarbazin Medac | Dacmed | Deticene | Detimedac;
  • (ES) Spain: Dacarbazina almirall | Dacarbazina medac;
  • (ET) Ethiopia: Oncodac;
  • (FI) Finland: Dacarbazine lipomed | Dacarbazine medac | Dacatic;
  • (FR) France: Dacarbazine Dci | Dacarbazine lipomed | Dacarbazine medac | Deticene;
  • (GB) United Kingdom: Dacarbazine;
  • (GR) Greece: Dacarbazine medac | Dacarbazine/medac | Dacarbion | Deticene;
  • (HR) Croatia: Dacarbazine Pliva;
  • (HU) Hungary: Dacarbazine lipomed | Dacin lipomed | Dakarbazin | Dakarbazin medac | Deticene;
  • (ID) Indonesia: Dacarbazine medac;
  • (IN) India: Celdaz | Dabaz | Dacarzine | Dazine | Decarb | Zicarb;
  • (IT) Italy: Dacarbazina lipomed | Dacarbazina medac | Deticene;
  • (KR) Korea, Republic of: Deticene | Deticin | Detimedac | DTI | Dtic-dome;
  • (LT) Lithuania: Celdaz | Dacarbazin | Dacarbazine medac | Deticene | Detimedac | Dtic;
  • (LV) Latvia: Dacarbazin Medac | Deticene | Dtic;
  • (MX) Mexico: Acocarb | Dacarbazina | Deticeme | Detilem | Ifadac | Onecobax | Tiferomed;
  • (NL) Netherlands: Dacarbazin | Dacarbazine medac | Deticene;
  • (NO) Norway: Dacarbazine lipomed | Dacarbazine medac;
  • (PA) Panama: Dacarbazina;
  • (PE) Peru: Celdaz | Dacarbazina | Deticene | Oncocarbil;
  • (PH) Philippines: Arzi | Duticin;
  • (PK) Pakistan: Darbazine | Decarb;
  • (PL) Poland: Dacarbazin | Dacarbazine medac | Dacin | Deticene | Detimedac | Dtic;
  • (PR) Puerto Rico: Dacarbazine | Dtic-dome;
  • (PT) Portugal: Dacarbazina | Deticene | Detimedac | Fauldetic;
  • (PY) Paraguay: Dacarbazina cipla | Dacarbazina fusa | Dacarzin;
  • (RO) Romania: Dacarbazina lipomed | Dacarbazine medac | Daltrizen | Detimedac;
  • (RU) Russian Federation: Dacarbazin | Dacarbazine lens | Dacarbazine medac | Dacarbazine rus | Dakarbazin;
  • (SA) Saudi Arabia: Dacarbazine | Dacarbazine medac | Dacin | Deticene;
  • (SE) Sweden: Dacarbazine medac;
  • (SI) Slovenia: Dacarbazin | Dacarbazine App | Dacarbazine lipomed | Dacin | Detimedac | DTIC-Dome;
  • (SK) Slovakia: Dacarbazin | Dakarbazin medac;
  • (TH) Thailand: Dacarbazine medac | Dacmed;
  • (TN) Tunisia: Dacin | Deticene | Detimedac;
  • (TR) Turkey: Dakarbaz | Deticene;
  • (TW) Taiwan: Dtic-dome;
  • (UA) Ukraine: Dacarbazin | Dacarbazin Medac | Dacarbazine lens | Dacin;
  • (UY) Uruguay: Dacarbazina | Dacarbazina Filaxis | Dacarzin | Oncocarbil;
  • (ZA) South Africa: Dacin | Daraz | Dtic-dome;
  • (ZM) Zambia: Decarb;
  • (ZW) Zimbabwe: Arzi
  1. Antman K, Crowley J, Balcerzak SP, et al, “An Intergroup Phase III Randomized Study of Doxorubicin and Dacarbazine With or Without Ifosfamide and Mesna in Advanced Soft Tissue and Bone Sarcomas,” J Clin Oncol, 1993, 11(7):1276-85. [PubMed 8315425]
  2. Antman K, Crowley J, Balcerzak SP, et al, “A Southwest Oncology Group and Cancer and Leukemia Group B phase II Study of Doxorubicin, Dacarbazine, Ifosfamide, and Mesna in Adults With Advanced Osteosarcoma, Ewing's Sarcoma, and Rhabdomyosarcoma,” Cancer, 1998, 82(7):1288-95. [PubMed 9529020]
  3. Avilés A, Nambo MJ, Neri N. Treatment of early stages Hodgkin lymphoma during pregnancy. Mediterr J Hematol Infect Dis. 2018;10(1):e2018006. doi:10.4084/MJHID.2018.006 [PubMed 29326803]
  4. Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol. 2004;22(14):2835-2841. doi: 10.1200/JCO.2004.12.170. [PubMed 15199092]
  5. Bonfante V, Santoro A, Viviani S, et al, “ABVD in the Treatment of Hodgkin's Disease,” Semin Oncol, 1992, 19(2 Suppl 5):38-44. [PubMed 1384143]
  6. Chapman PB, Einhorn LH, Meyers ML, et al. Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol. 1999;17(9):2745-2751. doi:10.1200/JCO.1999.17.9.2745 [PubMed 10561349]
  7. Clarkson DM, Harvey R, Sheepy D. Light protection of chemotherapy drugs for infusion. Med Eng Phys. 2015;37(2):233-238. doi:10.1016/j.medengphy.2014.11.010 [PubMed 25556147]
  8. Cohen V, Jellinek SP, Teperikidis L, et al. Room-temperature storage of medications labeled for refrigeration. Am J Health-Syst Pharm. 2007;64(16):1711-1715. [PubMed 17687059]
  9. Connors JM, Jurczak W, Straus DJ, et al; ECHELON-1 Study Group. Brentuximab vedotin with chemotherapy for stage III or IV Hodgkin's lymphoma [published correction appears in: N Engl J Med. 2018;378(9):878.]. N Engl J Med. 2018;378(4):331-344. doi: 10.1056/NEJMoa1708984. [PubMed 29224502]
  10. Cotteret C, Pham YV, Marcais A, Driessen M, Cisternino S, Schlatter J. Maternal ABVD chemotherapy for Hodgkin lymphoma in a dichorionic diamniotic pregnancy: a case report. BMC Pregnancy Childbirth. 2020;20(1):231. doi:10.1186/s12884-020-02928-6 [PubMed 32306909]
  11. Dacarbazine for injection [prescribing information]. Lake Zurich, IL: Fresenius Kabi; July 2022.
  12. Dacarbazine for injection [product monograph] Saint-Laurent, Quebec, Canada: Hospira Healthcare Corporation; December 2015.
  13. de Armas S, Huertas-Ayala C, Chan RY, et al. Survival of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) at a single institution. Pediatr Blood Cancer. 2022;69(5):e29601. doi:10.1002/pbc.29601 [PubMed 35187850]
  14. El Aatmani M1, Poujol S, Astre C, et al. Stability of dacarbazine in amber glass vials and polyvinyl chloride bags. Am J Health Syst Pharm. 2002;59(14):1351-1356. [PubMed 12132562]
  15. Engert A, Franklin J, Eich HT, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25(23):3495-3502. [PubMed 17606976]
  16. Engert A, Plütschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med. 2010;363(7):640-652. doi: 10.1056/NEJMoa1000067. [PubMed 20818855]
  17. Evens AM, Advani R, Press OW, et al. Lymphoma occurring during pregnancy: antenatal therapy, complications, and maternal survival in a multicenter analysis. J Clin Oncol. 2013;31(32):4132-4139. doi:10.1200/JCO.2013.49.8220 [PubMed 24043736]
  18. Flaherty LE, Othus M, Atkins MB, et al. Southwest Oncology Group S0008: a phase III trial of high-dose interferon Alfa-2b versus cisplatin, vinblastine, and dacarbazine, plus interleukin-2 and interferon in patients with high-risk melanoma--an intergroup study of cancer and leukemia Group B, Children's Oncology Group, Eastern Cooperative Oncology Group, and Southwest Oncology Group. J Clin Oncol. 2014;32(33):3771-3778. doi:10.1200/JCO.2013.53.1590 [PubMed 25332243]
  19. García-Del-Muro X, López-Pousa A, Maurel J, et al; Spanish Group for Research on Sarcomas. Randomized phase II study comparing gemcitabine plus dacarbazine versus dacarbazine alone in patients with previously treated soft tissue sarcoma: a Spanish Group for Research on Sarcomas study. J Clin Oncol. 2011;29(18):2528-2533. doi:10.1200/JCO.2010.33.6107 [PubMed 21606430]
  20. Griggs JJ, Bohlke K, Balaban EP, et al. Appropriate systemic therapy dosing for obese adult patients with cancer: ASCO guideline update. J Clin Oncol. 2021;39(18):2037-2048. doi:10.1200/JCO.21.00471 [PubMed 33939491]
  21. Herrstedt J, Clark-Snow R, Ruhlmann CH, et al; participants of the MASCC/ESMO Consensus Conference 2022. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open. 2024;9(2):102195. doi:10.1016/j.esmoop.2023.102195 [PubMed 38458657]
  22. Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO guideline update. J Clin Oncol. 2020;38(24):2782-2797. doi:10.1200/JCO.20.01296 [PubMed 32658626]
  23. Hochberg J, Basso J, Shi Q, et al. Risk-adapted chemoimmunotherapy using brentuximab vedotin and rituximab in children, adolescents, and young adults with newly diagnosed Hodgkin's lymphoma: a phase II, non-randomized controlled trial. J Immunother Cancer. 2022;10(5):e004445. doi:10.1136/jitc-2021-004445 [PubMed 35584865]
  24. Hodson L, Ovesen J, Couch J, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Managing hazardous drug exposures: information for healthcare settings, 2023. https://doi.org/10.26616/NIOSHPUB2023130. Updated April 2023. Accessed December 27, 2024.
  25. Huang H, Abraham J, Hung E, et al. Treatment of malignant pheochromocytoma/paraganglioma with cyclophosphamide, vincristine, and dacarbazine: recommendation from a 22-year follow-up of 18 patients. Cancer. 2008;113(8):2020-2028. [PubMed 18780317]
  26. Hutchinson RJ, Fryer CJ, Davis PC, et al, “MOPP or Radiation in Addition to ABVD in the Treatment of Pathologically Staged Advanced Hodgkin's Disease in Children: Results of the Children's Cancer Group Phase III Trial,” J Clin Oncol, 1998, 16(3):897-906. [PubMed 9508171]
  27. Hwang JP, Feld JJ, Hammond SP, et al. Hepatitis B virus screening and management for patients with cancer prior to therapy: ASCO provisional clinical opinion update. J Clin Oncol. 2020;38(31):3698-3715. doi:10.1200/JCO.20.01757 [PubMed 32716741]
  28. Johnson P, Federico M, Kirkwood A, et al. Adapted treatment guided by interim PET-CT scan in advanced Hodgkin's lymphoma. N Engl J Med. 2016;374(25):2419-2429. doi:10.1056/NEJMoa1510093 [PubMed 27332902]
  29. Kantrowitz-Gordon I, Hays K, Kayode O, et al. Pharmacokinetics of dacarbazine (DTIC) in pregnancy. Cancer Chemother Pharmacol. 2018;81(3):455-460. doi:10.1007/s00280-017-3511-6 [PubMed 29305638]
  30. Kintzel PE and Dorr RT, "Anticancer Drug Renal Toxicity and Elimination: Dosing Guidelines for Altered Renal Function," Cancer Treat Rev, 1995, 21(1):33-64. [PubMed 7859226]
  31. Krens SD, Lassche G, Jansman FGA, et al. Dose recommendations for anticancer drugs in patients with renal or hepatic impairment. Lancet Oncol. 2019;20(4):e200-e207. doi:10.1016/S1470-2045(19)30145-7 [PubMed 30942181]
  32. Lambertini M, Peccatori FA, Demeestere I, et al; ESMO Guidelines Committee. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO clinical practice guidelines. Ann Oncol. 2020;31(12):1664-1678. doi:10.1016/j.annonc.2020.09.006 [PubMed 32976936]
  33. Lishner M, Avivi I, Apperley JF, et al. Hematologic Malignancies in Pregnancy: Management Guidelines From an International Consensus Meeting. J Clin Oncol. 2016;34(5):501-508. [PubMed 26628463]
  34. Marchesi F, Turriziani M, Tortorelli G, et al, “Triazene Compounds: Mechanism of Action and Related DNA Repair Systems,” Pharmacol Res, 2007, 56(4):275-87. [PubMed 17897837]
  35. Mauz-Körholz C, Landman-Parker J, Balwierz W, et al. Response-adapted omission of radiotherapy and comparison of consolidation chemotherapy in children and adolescents with intermediate-stage and advanced-stage classical Hodgkin lymphoma (EuroNet-PHL-C1): a titration study with an open-label, embedded, multinational, non-inferiority, randomised controlled trial. Lancet Oncol. 2022;23(1):125-137. doi:10.1016/S1470-2045(21)00470-8 [PubMed 34895479]
  36. Metzger ML, Link MP, Billett AL, et al. Excellent outcome for pediatric patients with high-risk Hodgkin lymphoma treated with brentuximab vedotin and risk-adapted residual node radiation. J Clin Oncol. 2021;39(20):2276-2283. doi:10.1200/JCO.20.03286 [PubMed 33826362]
  37. Meyer RM, Gospodarowicz MK, Connors JM, et al, “Randomized Comparison of ABVD Chemotherapy With a Strategy That Includes Radiation Therapy in Patients With Limited-Stage Hodgkin's Lymphoma: National Cancer Institute of Canada Clinical Trials Group and the Eastern Cooperative Oncology Group,” J Clin Oncol, 2005, 23(21):4634-42. [PubMed 15837968]
  38. Middleton MR, Grob JJ, Aaronson N, et al, “Randomized Phase III Study of Temozolomide Versus Dacarbazine in the Treatment of Patients With Advanced Metastatic Malignant Melanoma,” J Clin Oncol, 2000, 18(1):158-66. [PubMed 10623706]
  39. National Toxicology Program. NTP monograph: developmental effects and pregnancy outcomes associated with cancer chemotherapy use during pregnancy. NTP Monogr. 2013;(2):i-214. [PubMed 24736875]
  40. Nocera M, Baudin E, Pellegriti G, Cailleux AF, Mechelany-Corone C, Schlumberger M. Treatment of advanced medullary thyroid cancer with an alternating combination of doxorubicin-streptozocin and 5 FU-dacarbazine. Groupe d'Etude des Tumeurs à Calcitonine (GETC). Br J Cancer. 2000;83(6):715-718. doi:10.1054/bjoc.2000.1314 [PubMed 10952773]
  41. Orlandi F, Caraci P, Berruti A, et al. Chemotherapy with dacarbazine and 5-fluorouracil in advanced medullary thyroid cancer. Ann Oncol. 1994;5(8):763-765. [PubMed 7826911]
  42. Ovesen JL, Sam­mons D, Connor TH, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. NIOSH list of hazardous drugs in healthcare settings, 2024. https://doi.org/10.26616/NIOSHPUB2025103. Updated December 18, 2024. Accessed December 20, 2024.
  43. Paw Cho Sing E, Robinson PD, Flank J, et al. Classification of the acute emetogenicity of chemotherapy in pediatric patients: A clinical practice guideline. Pediatr Blood Cancer. 2019;66(5):e27646. doi:10.1002/pbc.27646 [PubMed 30729654]
  44. Peccatori FA, Azim HA Jr, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi160-167. [PubMed 23813932]
  45. Pérez Fidalgo JA, García Fabregat L, Cervantes A, et al. Management of chemotherapy extravasation: ESMO-EONS clinical practice guidelines. Ann Oncol. 2012;23(Suppl 7):vii167-173. [PubMed 22997449]
  46. Perry MC. Chemotherapeutic agents: Dacarbazine. The Chemotherapy Source Book. 5th ed. Philadelphia, PA: 2012.
  47. Pinnix CC, Osborne EM, Chihara D, et al. Maternal and fetal outcomes after therapy for Hodgkin or non-Hodgkin lymphoma diagnosed during pregnancy. JAMA Oncol. 2016;2(8):1065-1069. doi:10.1001/jamaoncol.2016.1396 [PubMed 27227654]
  48. Ramanathan RK, Cnaan A, Hahn RG, et al, “Phase II Trial of Dacarbazine (DTIC) in Advanced Pancreatic Islet Cell Carcinoma, Study of the Eastern Cooperative Oncology Group-E6282,” Ann Oncol, 2001, 12(8):1139-43. [PubMed 11583197]
  49. Robert C, Thomas L, Bondarenko I, et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;364(26):2517-2526. doi:10.1056/NEJMoa1104621 [PubMed 21639810]
  50. Rusthoven JJ, Quirt IC, Iscoe NA, et al, “Randomized, Double-Blind, Placebo-Controlled Trial Comparing the Response Rates of Carmustine, Dacarbazine, and Cisplatin With and Without Tamoxifen in Patients With Metastatic Melanoma. National Cancer Institute of Canada Clinical Trials Group” J Clin Oncol, 1996, 14(7):2083-90. [PubMed 8683240]
  51. Schlumberger M, Abdelmoumene N, Delisle MJ, et al. Treatment of advanced medullary thyroid cancer with an alternating combination of 5 FU-streptozocin and 5 FU-dacarbazine. The Groupe d'Etude des Tumeurs a Calcitonine (GETC). Br J Cancer. 1995;71(2):363-365. [PubMed 7530987]
  52. Straus DJ, Portlock CS, Qin J, et al, “Results of a Prospective Randomized Clinical Trial of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine (ABVD) Followed by Radiation Therapy (RT) Versus ABVD Alone for Stages I, II, and IIIA Nonbulky Hodgkin Disease,” Blood, 2004, 104(12):3483-9. [PubMed 15315964]
  53. Traila A, Dima D, Achimas-Cadariu P, Micu R. Fertility preservation in Hodgkin's lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era. Cancer Manag Res. 2018;10:1517-1526. doi:10.2147/CMAR.S154819 [PubMed 29942153]
  54. United States Pharmacopeia. <800> Hazardous Drugs—Handling in Healthcare Settings. In: USP-NF. United States Pharmacopeia; July 1, 2020. Accessed January 16, 2025. doi:10.31003/USPNF_M7808_07_01
  55. Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567-610. [PubMed 25810047]
  56. Wu LT, Averbuch SD, Ball DW, et al. Treatment of advanced medullary thyroid carcinoma with a combination of cyclophosphamide, vincristine, and dacarbazine. Cancer. 1994;73(2):432-436. [PubMed 8293411]
  57. Zalupski M, Metch B, Balcerzak S, et al. Phase III comparison of doxorubicin and dacarbazine given by bolus versus infusion in patients with soft-tissue sarcomas: a Southwest Oncology Group study. J Natl Cancer Inst. 1991;83(13):926-932. [PubMed 2067035]
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