Informational only — Not medical advice. Always consult a licensed healthcare provider.

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Decitabine

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Indications

Decitabine-Sun is used to treat adults with myelodysplastic syndromes (MDS). This covers MDS that has been treated before and MDS that has not, and both de novo and secondary MDS. It applies to all French-American-British subtypes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia. It is also used across the intermediate-1, intermediate-2 and high-risk International Prognostic Scoring System groups.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Decitabine is believed to work against cancer cells after it has been phosphorylated and built directly into DNA. Once it is in the DNA, it inhibits DNA methyltransferase. This causes hypomethylation of DNA, and the cell then goes on to differentiate or undergo apoptosis. In vitro, it inhibits DNA methylation at concentrations that do not cause major suppression of DNA synthesis. In neoplastic cells, the hypomethylation may restore normal function to genes that are critical for the control of cellular differentiation and proliferation. In rapidly dividing cells, its cytotoxicity may also come from covalent adducts that form between DNA methyltransferase and the drug already incorporated into DNA. Non-proliferating cells are relatively insensitive to decitabine.

Pregnancy & Breastfeeding

Decitabine can harm an unborn baby if it is given to a pregnant woman. This comes from human data and animal studies, and also from how the medicine works in the body. Mothers should not breastfeed while on it. Nobody knows yet whether decitabine or its metabolites pass into human milk, what effect they might have on a breastfed child, or whether they change milk production.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Three day regimen: give DACOGEN at a dose of 15 mg/m2 as a continuous intravenous infusion over 3 hours, repeated every 8 hours for 3 days. Repeat the cycle every 6 weeks once the blood counts have recovered (ANC at least 1,000/µL and platelets at least 50,000/µL), for a minimum of 4 cycles. A complete or partial response may take longer than 4 cycles. Delay the dose and reduce it if there is hematologic toxicity. Five day regimen: give DACOGEN at a dose of 20 mg/m2 as a continuous intravenous infusion over 1 hour daily for 5 days. Delay and reduce the dose for hematologic toxicity (see Dose Modifications for Toxicity). Repeat the cycle every 4 weeks once the blood counts have recovered (ANC at least 1,000/µL and platelets at least 50,000/µL), for a minimum of 4 cycles. A complete or partial response may take longer than 4 cycles.