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Dacarbazine (DTIC)

Dacarbazine is a chemotherapy drug. It is also called DTIC. It is a treatment for several cancers that have spread (advanced cancer), including:

  • melanoma skin cancer
  • soft tissue sarcoma
  • Hodgkin lymphoma

How dacarbazine works

Dacarbazine belongs to a group of chemotherapy drugs called alkylating agents. It works by sticking to the cancer cell's DNA and damaging it. 

The DNA is the genetic code that controls everything the cell does. If the DNA is damaged, the cancer cell cannot divide and make more cancer cells. 

How you have dacarbazine

Dacarbazine is a liquid that you have into your bloodstream. You might have it as a slow injection over a few minutes. Or as a drip over 15 to 30 minutes.

Into your bloodstream

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

If you don't have a central line

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

When you have dacarbazine

You usually have dacarbazine as a course of several cycles of treatment. The course depends on your type of cancer. You can have dacarbazine alone or in combination with other chemotherapy drugs.

Your doctor or nurse will tell you more about your cycle of treatment.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

Increased risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums or nose bleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Tiredness and weakness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • hair thinning
  • skin problems – such as darker areas of skin, sensitivity to the sun, redness, raised bumps, itching or your skin may feel hot and sting
  • flu-like symptoms a few days after treatment – runny nose, headaches, high temperature, chills, muscle pain – call your advice line if you have a temperature or feel unwell
  • inflammation at the drip site – tell your nurse if you have any pain or swelling around the site
  • an allergic reaction – you may get a rash, shortness of breath, redness or swelling of the face - tell your nurse straight away if you have any of these symptoms
  • headaches
  • changes to your eye sight
  • feeling confused
  • fits (convulsions)
  • part of your face may not be able to move (facial paraesthesia) – if this happens it is normally shortly after having the drug
  • redness and feeling warm in your face (facial flushing) – usually shortly after having the drug
  • diarrhoea
  • problems with your liver – your blood test results may show changes to your liver - tell your doctor or nurse straightaway if you have a high temperature, tummy (abdominal) pain or your skin and whites of your eyes look yellow (jaundiced)
  • problems with your kidneys – you may not be passing enough urine, your urine might be darker than normal or your blood test results may show changes to how well your kidneys are working

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drinks

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. 

Women must use reliable contraception during treatment. Men must use reliable contraception during treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Driving and use of machinery

This drug can cause headaches and confusion, problems with your eye sight, tiredness, fits and feeling or being sick.

Don’t drive or operate heavy machinery if you have these symptoms.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help