Azacitidine is believed to cause hypomethylation of DNA and direct cytotoxicity on abnormal hematopoietic cells in the bone marrow. Abnormal cells, including cancer cells, no longer respond to normal growth control mechanisms. The cytotoxic effects of azacitidine cause the death of these cells while nonproliferating cells are relatively insensitive to the medication.

75 mg/m² daily for seven days every four weeks; increase to 100 mg/m² if no beneficial effect was seen after two treatment cycles.

Indicated for the treatment of patients with specific subtypes of myelodysplastic syndrome.

Bone marrow suppression, including neutropenia, thrombocytopenia, and anemia. Additional side effects seen include nausea, vomiting, diarrhea, fatigue, fever, erythema at injection site, elevated serum creatinine, renal failure, hypokalemia, renal tubular acidosis, and hepatic coma.

Gently roll syringe between palms to mix medication. Administer azacitidine subcutaneously. Divide doses greater than 4 ml into two syringes and inject into two separate sites. Rotate sites for administration among thigh, abdomen, and upper arm. Administer new injections at least one inch from old site. Avoid sites that are tender, bruised, red, or hard.

Monitor blood counts and liver and renal function during therapy.

Azacitidine requires the use of chemotherapy safe-handling precautions.

Azacitidine is contraindicated in patients with hypersensitivity to azacitidine or mannitol and those with advanced malignant hepatic tumors.

This medication has been shown to have teratogenic effects. Female patients should avoid becoming pregnant while taking this medication. Male patients should be advised not to father a child while receiving azacitidine therapy.

Must be administered within one hour after reconstitution at room temperature. For delayed administration, may be refrigerated for up to eight hours. Allow refrigerated solution to come to room temperature for 30 minutes prior to administration.