Temozolomide Chemotherapy Pill

What Is Temozolomide?

Temozolomide is a chemotherapy drug designed to kill and slow the growth of cancer cells in the brain known as glioblastoma. Today, however, besides brain tumors , it is also used in many other cancers. Temozolomide, by inhibiting DNA synthesis , slows tumor tissue growth and is a prodrug.

Note: The active ingredient temozolamid is available on the market under the names Temodal, Temomid and Temozolid .

When Is Temozolomide Used (Indications)?

Temozolomide is taken to shrink tumors and make them more sensitive to radiotherapy . Radiotherapy (radiation treatment) and temozolomide are generally not given to achieve a complete cure, but they may reduce signs and symptoms associated with GBM-IV (glioblastoma multiforme) and other brain tumors and extend lifespan.

It is also used for brain tumors recurring after standard treatment during drug-free follow-up, and continued until cancer progression.

Temozolomide capsules are also used in other cancers (such as malignant melanoma, pleural tumors and breast cancer).

How Is Temozolomide Used?

Temozolomide is available as capsules in doses of 5 mg, 20 mg, 100 mg and 250 mg. Treatment starts after the physician calculates the appropriate dose according to body measurements (height and weight).

In brain tumors, adjuvant (postoperative protective) temozolomide administration: In operated brain tumors, it is taken concurrently with radiotherapy, to increase radiotherapy's effectiveness, throughout the radiotherapy course (an average of 42 days), at a low dose (75 mg/m2) every day. After radiotherapy, treatment is interrupted for 28 days.

After 28 days, maintenance treatment is taken for 5 days (150-200 mg/m2), followed by a 23-day break. A 28-day period is considered 1 cycle. This treatment usually continues for 6 months.

Before each cycle, blood values and the patient's general condition are assessed, and the temozolomide dose may be adjusted or delayed, or temozolomide treatment may be stopped.

For other cancer types, the physician determines the dose. Generally, 150 -200 mg/m2 on days 1-5 every 28 days is recommended.

Depending on your blood values and/or tolerance of treatment, the physician may reduce the dose or stop treatment.

• Because your temozolomide (Temodal, Temomid, Temozolid) interacts with food, you should wait without eating or drinking anything either 1 hour before a meal or 2 hours after eating, and then take Temodal.
• When taking the medicine, swallow it with a large glass of water without holding it in the mouth or opening the capsules.
• Then go to radiotherapy after 2 hours without eating or drinking anything. Eating after radiotherapy is acceptable.
• For temozolomide monotherapy (single-drug treatment), the medicine may be taken 1 hour before or 2 hours after eating.
• If a capsule is damaged, avoid contact between its powdered contents and the skin or inside of the mouth. If contact occurs, wash the area thoroughly with water.
• Consume 3 liters of fluid throughout the day.
• If a dose is forgotten or vomiting occurs after taking the medicine, do not take another dose to replace it. Skip the missed dose (do not take a double dose). 
• The medicine must not be used during pregnancy or breastfeeding.
• Store the medicine below 30 degrees in a place protected from sunlight.
• Throughout treatment, using protective methods, sexual activity may continue.

How Often Is Follow-Up Necessary While Taking Temozolomide?

If used concurrently with radiotherapy, monitoring with weekly blood tests is recommended. During maintenance treatment, taking the patient's general condition into account, blood values and patient performance are assessed before each treatment every 28 cycles, and treatment is started. Required blood tests are a complete blood count (hemogram) and a comprehensive metabolic panel (biochemistry).

How Often Is Radiological Imaging Necessary?

Brain magnetic resonance imaging (MRG) may be checked before treatment, 2 to 6 weeks after treatment, and during the first 2 to 4 years every 2-4 months. Other imaging may include computed tomography (CT) scans and bone scans.

How Do Blood Test Results / Imaging Affect Treatment?

Depending on the results, your doctor may recommend continuing capecitabine as planned, delaying treatment or changing it.

Is Temozolamid Reimbursed by SGK? 

For a cancer diagnosis, no indication requirement is sought, and reimbursement is available. 

Price: As of August 2025 Temodal 100 mg 5 capsules 3.300.35 TL, Temodal 20 mg 5 capsules 810,06 TL, Temodal 5 mg 5 capsules 154,86 TL, Temodal 250 mg 5 capsules 8.327,14 TL. 

What Are the Adverse Effects of Temozolomide (Temodal, Temomid, Temozolid)?

The adverse effects most commonly reported in clinical studies with temozolomide given concurrently with radiotherapy are shown here: 

• Fatigue (% 33) 
• Vision changes (% 15)
• Nausea or vomiting (% 13) 
• Rash [skin allergies] (% 10) 
• Low white blood cells [leukopenia] (% 4) 
• Infection (% 4) 
• Increased bleeding risk [low platelets] (% 3) 
• Anemia [low red blood cells] (% 1)

Note: Nausea, vomiting and constipation may be more common in patients older than 65.

On average, % 5 of patients did not continue temozolomide because of unacceptable adverse effects.

What Should Be Considered While Taking Temozolomide?

• A notable adverse effect of temozolomide is nausea. To avoid nausea and vomiting, temozolamid may be taken before bedtime. The doctor's recommended anti-nausea medicines may be used. 
• Temozolomide is available in several different doses. Make sure the correct dose of medicine is taken.
• Caffeinated foods (cola, coffee, etc.) may increase headaches. 
• It may cause constipation, fatigue and headache.
• It may alter taste in the mouth. 
• It may cause restlessness and insomnia. 
• It may rarely cause hair loss. 
• It may cause dizziness. Do not get out of bed suddenly.
• Sudden movements should be avoided.
• It may reduce your blood values.
• Be careful to avoid falls and impacts because of bleeding risk.
• If a fever of 38-38,5 degrees occurs, contact the nearest healthcare facility or emergency department without taking any fever-reducing medicine.
• If watery diarrhea occurs more than 3-4 times a day, contact the nearest healthcare facility or emergency department.
• If an allergic reaction resembling a rash occurs, contact the nearest healthcare facility or emergency department.