Temozolomide is a chemotherapy drug used to treat a type of brain caner called a glioma. Temozolomide comes in capsules and can be taken by itself or with radiotherapy.

HOW IS TEMOZOLOMIDE ADMINISTERED?

Temozolomide is given in capsule form. Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.

You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy.

TAKING TEMOZOLOMIDE CAPSULES

Before you leave the hospital, your nurse or pharmacist will give you the capsules to take home with you. Always take the capsules exactly as you are instructed. This is important to ensure that it is working as well as possible.

Your shouldn't eat anything one hour before or one hour after taking the capsules. They should be swallowed whole with a glass of water and should not be opened or chewed. You should take the capsules at the same time each day.

Other things to keep in mind regarding your capsules:

• Keep them in their original packaging at room temperature. They should be stored away from heat and direct sunlight.
• Keep them safe and out of the reach of children.
• Return any remaining capsules to the hospital if the treatment is discontinued.

Caregivers should wear disposable gloves when handling the capsules.

YOUR CHEMOTHERAPY CYCLE

You will have chemotherapy as part of a course or cycle, consisting of several treatment sessions and lasting several months. Your course will depend on whether or not you are receiving radiotherapy. Your doctor or nurse will tell you more about this and how many cycles you are going to have.

POSSIBLE SIDE EFFECTS OF TEMOZOLOMIDE

You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.

Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.

RISK OF INFECTION

Temozolomide may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.

Contact your hospital immediately if any of the following happens:

• your temperature goes above 38 ° C
• you suddenly feel unwell, even if your temperature is normal.
• You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.

BRUISING AND BLEEDING

Temozolomide may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.

ANEMIA

Temozolomide may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.

NAUSEA

This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.

If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.

CONSTIPATION

Temozolomide can cause constipation and abdominal pain. Drinking at least two liters of fluids each day will help if this is the case. Try to eat more high-fiber foods such as fruit, vegetables, and whole-grain bread and get some light exercise.

If you have not had a bowel movement in two days, contact your hospital for advice. Your doctor can prescribe laxatives to help with this.

LOSS OF APPETITE

You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They can give you nutritional supplements or good-tasting meal-replacement drinks.

TIREDNESS

Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.

HEADACHES AND SEIZURES

Temozolomide can cause headaches. Tell your doctor or nurse if you have headaches. They can give you painkillers to help. In rare cases, this treatment can cause seizures. Tell your doctor or nurse immediately if you have any of these symptoms. They can make changes in your treatment if they become a problem for you.

It is important not to drive or operate machinery if you notice these effects.

HIGH BLOOD SUGAR LEVELS

Temozolomide can raise your blood sugar. Your nurse will give you regular blood tests. They may also perform a urine analysis to check for sugar levels. The symptoms of raised blood sugar include a feeling of thirstiness, a need to urinate more frequently, and feeling tired. Tell your doctor or nurse if you have these symptoms.

If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need for your insulin dose to be changed.

HAIR LOSS

Your hair may thin out, though it is unlikely you will lose all of the hair on your head. Hair loss normally starts after your first or second cycle of chemotherapy. It is almost always temporary, and the hair will continue to grow after you finish your treatment. Your nurse can give you advice on how to cope with losing your hair.

SKIN CHANGES

Chemotherapy can affect your skin. Temozolomide can produce a rash, which may cause itchiness. If your skin is dry, try to use a fragrance-free moisturizing cream every day. Always tell your doctor about any change to your skin. These changes can be temporary, improving once the treatment is over.

DIFFICULTY BREATHING

Temozolomide can cause changes in the lungs. Always let your doctor know if you have wheezing, coughing, fever, or if you are out of breath. If necessary, tests can be done to check your lungs.

MORE INFORMATION ABOUT TEMOZOLOMIDE

BLOOD CLOT RISK

Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.

OTHER DRUGS

Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.

FERTILITY

Temozolomide may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.

CONTRACEPTION

Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.

SEX

If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.

BREASTFEEDING

Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.

MEDICAL AND DENTAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.

Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.