decitabine / cedazuridine
Other Name: Inqovi®
Oval-shaped red tablets
- For treating a group of blood cancers called myelodysplastic syndromes (MDS) including chronic myelomonocytic leukemia (CMML).
Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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kidney or liver problems
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lung disease
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a low blood cell count (platelets, red or white blood cells)
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an infection or flu-like symptoms or
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any allergies
Decitabine / cedazuridine tablets contains a small amount of lactose. If you cannot have lactose, talk to your health care team.
Remember to:
- Tell your health care team about all of the other medications you are taking.
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Talk to your health care team about:
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How this medication may affect your sexual health.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
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If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until 6 months after your last dose if you are female and 3 months after your last dose if you are male. Talk to your health care team about which birth control options are best for you.
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Do not breastfeed while on this medication and for at least 2 weeks after your last dose.
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This medication is usually taken once a day by mouth for 5 days in a row. This is followed by 23 days with no treatment. Talk to your health care team about how and when to take your medication.
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Swallow whole with a glass of water on an empty stomach, at least 2 hours before or after food.
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Do not cut, crush or chew the tablets.
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If you miss a dose, take it if it is within 12 hours from the missed dose, otherwise skip and take your next dose as scheduled. Extend your dosing period by one day for every missed dose to complete all 5 doses. Do not double the dose to make up for the forgotten dose.
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If you vomit (throw up) after taking a dose of decitabine / cedazuridine, do not take an additional dose on that day. Take your next scheduled dose at your usual time.
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If you take too much of your medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
To Prevent or Treat Nausea and Vomiting
Anti-nausea medications are used to prevent or stop nausea (feeling like throwing up) and vomiting (throwing up) before they start. You may be given these medications.
- Anti-nausea medications to prevent nausea and vomiting before they start include ondansetron (Zofran®), granisetron (Kytril®), or others.
If you already have nausea and/or vomiting, some anti-nausea medication can stop them from getting worse. You may be given anti-nausea medications to have at home in case you start to feel nausea or if you vomit.
- Anti-nausea medications to stop nausea and vomiting include prochlorperazine (Stemetil®), metoclopramide (Maxeran®), or others.
Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
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If you need to take medications to help with heartburn, acid reflux or a stomach ulcer (such as calcium carbonate, ranitidine or omeprazole), take it 4 hours before or after you take your decitabine / cedazuridine tablet.
What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
OR
- 38.0°C (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:
- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
What to DO while on this medication:
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO tell your health care team about any serious infections that you have now or have had in the past.
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DO wear shoes that have nonslip soles and some ankle support. Also try to stand up slowly after sitting or lying down to lower your chance of falling down.
What NOT to DO while on this medication:
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DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel drowsy or dizzy.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
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What to do if oral anti-cancer medication gets on your skin or in your eyes
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:-
Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
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The following table lists side effects that you may have when getting decitabine / cedazuridine. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on decitabine / cedazuridine.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Low neutrophils (white blood cells) in the blood (neutropenia) (May be severe) When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information. What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do? If your health care team has told you that you have low neutrophils:
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Low platelets in the blood (May be severe) When your platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. |
Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe (very heavy), you MUST get emergency help right away. |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information.
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Talk to your health care team if it does not improve or if it is severe. |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information.
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Talk to your health care team if it does not improve or if it is severe. |
Mouth sores What to look for?
To help prevent mouth sores:
If you have mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow. |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
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Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe. |
Cough and feeling short of breath What to look for?
What to do?
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Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away. |
Diarrhea What to look for?
What to do? If you have diarrhea:
Ask your health care team for the Diarrhea pamphlet for more information. |
Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day). |
Dizziness What to look for?
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Talk to your health care team if it does not improve or if it is severe. |
Rash; dry, itchy skin What to look for?
What to do? To prevent and treat dry skin:
Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. |
Talk to your health care team if it does not improve or if it is severe. |
Mild swelling What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Low appetite, Weight loss What to look for?
What to do?
Ask your health care team for the Loss of Appetite pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Liver problems Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency help right away. |
Pains or cramps in the belly What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Kidney problems Your health care team may check for proteins in your urine (pee) and your kidney function regularly with a blood test. You may have blood in your urine. What to look for?
What to do?
To prevent kidney infections:
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Get emergency medical help right away. |
Neuropathy (Tingling, numb toes or fingers) What to look for?
What to do?
In rare cases, it may continue long after treatment ends. If you continue to have bothersome symptoms, talk to your health care team for advice. |
Talk to your health care team, especially if you have trouble doing tasks like doing up buttons, writing, moving, or if you have severe pain or numbness. |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe, |
Talk to your health care team if it does not improve or if it is severe. |
Heart problems What to look for?
What to do? Get emergency medical help right away.
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Get emergency medical help right away. |
Low blood pressure What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
- Signs of an allergic reaction: itchiness, rash, swollen lips, face or tongue, chest and throat tightness, especially during or shortly after the medication is given
- New swelling of arms, legs, neck, groin, or underarm area
- Unusual fast weight gain, bone pain
- Sudden fever, sore red spots or blisters mostly on the arms, face, neck, back or legs; unusual joint pain, sore eyes
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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February 2024 No change. Renamed document
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.