Dacarbazine is primarily used for the treatment of Metastatic Malignant Melanoma. It is also indicated for the treatment of Hodgkin Lymphoma as a second-line therapy, usually given in combination with other effective chemotherapy agents.

Dacarbazine is a non–cell cycle specific antineoplastic agent. The precise mechanism by which it produces cytotoxic effects remains unclear. However, several possible mechanisms have been proposed, including inhibition of DNA synthesis through its action as a purine analog, functioning as an alkylating agent, and interaction with sulfhydryl groups leading to inhibition of cellular growth.

Malignant Melanoma: The recommended dosage is 2 to 4.5 mg/kg/day for 10 days. Treatment may be repeated at 4 week intervals. An alternate recommended dosage is 250 mg/m²/day IV for 5 days. Treatment may be repeated every 3 weeks.

Hodgkin’s Disease: The recommended dosage of Dacarbazine in the treatment of Hodgkin’s disease is 150 mg/m²/day for 5 days, in combination with other effective drugs. Treatment may be repeated every 4 weeks. An alternative recommended dosage is 375 mg/m² on day 1, in combination with other effective drugs, to be repeated every 15 days.

Dacarbazine metabolism may increase when it is used together with enzyme-inducing drugs such as Rifampicin, Phenytoin, or barbiturates. It may enhance the effects or toxicity of drugs such as Mercaptopurine, Azathioprine, and Allopurinol. Dacarbazine may also reduce the immune response to vaccines and increase the photosensitizing effect of Methoxsalen.

Dacarbazine should not be used in patients who have previously shown hypersensitivity or allergic reactions to this drug.

The most common side effects of Dacarbazine include loss of appetite (anorexia), nausea, and vomiting. More than 90% of patients may experience these symptoms during the initial doses. Vomiting usually begins shortly after treatment and may last 1–12 hours. Anti-nausea medications such as Phenobarbital or Prochlorperazine may provide partial relief. In rare cases, severe nausea and vomiting may require discontinuation of therapy. Diarrhea has also been reported occasionally. To reduce these symptoms, patients are often advised to avoid food intake for 4–6 hours before treatment. These symptoms are believed to involve a central nervous system mechanism and usually improve after the first few days of therapy.

Dacarbazine is classified as Pregnancy Category C. Animal studies have shown that it may cause fetal abnormalities. Therefore, it should be used during pregnancy only if the potential benefits outweigh the possible risks. It is not known whether Dacarbazine passes into human breast milk. Because of the possible risk to infants, a decision should be made whether to stop breastfeeding or discontinue the drug depending on the importance of treatment for the mother.

When using Dacarbazine, proper laboratory monitoring should be available. Extravasation during intravenous injection may cause tissue damage and severe pain. Pain, burning, or irritation at the injection site may be relieved by applying warm compresses. Studies in animals have shown that Dacarbazine may have carcinogenic potential, as certain tumors were observed in experimental animals.

Overdose of Dacarbazine may lead to severe bone marrow suppression and gastrointestinal toxicity. Treatment includes supportive care and monitoring of blood cell counts.

Cytotoxic Chemotherapy

Store Dacarbazine in a refrigerator at 2°C–8°C.