Azacitidine (Injection)

Azacitidine intravenous injections are used to treat bone marrow cancers and blood cell disorders by inhibiting a process called DNA methylation, and is essential for cell reproduction - abnormal cancer cells die.


Azacitidine is in a class of medications called demethylation agents, helping to generate healthy blood cells and eradicating abnormal cells. The drug shares similar characteristics with natural chemical compounds found in our body, generating normal metabolic responses in our cells. The difference is its ability to restore or inhibit the division and growth of healthy or abnormal cells.

This drug comes in the form of a powder' mixing it with water and intravenously injecting the medicine into a vein by a medical professional in a medical office, chemotherapy facility or outpatient hospital department. Treatment cycles are seven days in a four-week cycle, increasing the dosage after two cycles.

Cancer medicines cause nausea - ask your doctor how to control this side effect.

Your doctor may extend the cycle of treatment depending on your health, side effects and any other medical conditions. Periodic blood work to monitor blood count, follow up on side effects and organ functions are part of treatment cycle' each one plays a critical role in verifying your response to this drug therapy.

Condition(s) Treated

Type of Medicine

  • Chemotherapy drug

Side Effects

There are side effects with azacitidine' they vary from person-to-person, and in some cases, unusual side effects do occur, caused from allergies or interactions with other drugs, foods or supplements. Before starting treatment, it is important to talk with your doctor and share your family and personal medical information. Your doctor may decrease or prevent some of the side effects, but not all of them.

  • If you have been diagnosed with liver or kidney disease, your doctor needs to know.
  • Make sure your doctor knows all prescription and non-prescription medications, vitamins, and nutritional supplements including herbal products you are taking now.
  • If you have dental appointments or other medical procedures scheduled' talk with your doctor before starting treatment.

Your doctor may need to change the dose, the schedule of treatment or the frequency of treatments due to existing health ailments. You may have to stop taking these items during treatment' by doing so, it may reduce the side effects and help your body re-establish your health.

Side effects do vary and levels of discomfort may be intensified with the addition of sensitivities or allergies to other chemicals. For most patients, you can expect common effects and some allergic reactions. There are options to help minimize or prevent these side effects' ask your doctor. Some effects occur quickly, others appear throughout the treatment. However, many will subside after each cycle, and most diminish after the final treatment is completed.

Here's a list of the known side effects, there may be a few new ones as you start your treatment. If you experience a serious side effect or unusual symptom, contact your doctor.

Allergy responses:

  • Paleness
  • Feeling light-headed
  • Short of breath
  • Rapid heart rate
  • Fever
  • Body aches
  • Flu symptoms
  • Sores in your mouth and throat
  • Bruising
  • Unusual bleeding
  • Red spots under your skin

More common

  • Injection site pain
  • Injection site redness
  • Low red blood cell count
  • Low platelet count
  • Nausea
  • Vomiting


Less common

Because treatments are administered in a medical facility, you can tell your doctor or the medical attendee about any side effects. Do not be shy about this as they cannot help if they do not know. After you get home, if you develop fever, it's important to contact your doctor' fevers are a sign of an infection. Infections can weaken your body and your immune system, increasing the health difficulties associated with this cancer treatment.

Here's some side effects that may not be an emergency, but they need medical attention. If any of these situations persist for 24 hours contact your doctor and head to the medical office.

  • Diarrhea
  • Black, tarry or bloody stool
  • Bladder pain
  • Bleeding gums
  • Blood or cloudy urine
  • Burning or stinging of the skin
  • Chest pain
  • Difficult breathing
  • Difficulty swallowing
  • Dizziness
  • Ear congestion
  • Fast heartbeat
  • Irregular heartbeat
  • Loss of consciousness
  • Painful urination

Side effects come with the treatment' they occur shortly after treatment and subside as your body adjusts to the medicine. Talk with your doctor, there may be options to prevent or at least reduce the effect.

Side effects are bothersome and if they don't fade away, your doctor may have a good solution to help you get through it. Ask questions about the side effects and share the details. Although the solution may not be immediate, it may make the afflictions of this treatment more bearable.

  • Acid or sour stomach
  • Appetite decreased
  • Belching
  • Bloated or pressure in the stomach
  • Blurred vision
  • Bumps on the skin
  • Dry skin
  • Fainting
  • Fear
  • Feeling cold or warm
  • Flushing
  • Heartburn
  • Heart murmur
  • Indigestion
  • Irritability
  • Loss of interest
  • Mouth hemorrhage
  • Muscle stiffness
  • Nervousness
  • Postnasal drip
  • Sweating
  • Tongue ulceration
  • Unusual drowsiness

Keep in mind, there may be other side effects not listed and your health status could change how your body reacts to the drug. If you experience any sickness or a new medical condition, notify your doctor or health care professional.


All medicinal doses are based on your health condition and the severity of the illness. The doctor will take into consideration other health problems that may interact with azacitidine triggering adverse effects. The good news, you will have a nurse or your doctor on site with you while you undergo treatment.

You should consider your diet' it needs to be healthy because your body will draw a great deal of energy and nourishment from it. At the same time, the treatments are going to make it more demanding for your body to do its normal tasks each day.


  • Azacitidine vials are 100 milligrams
  • First treatment is 75 milligrams increasing to 100 milligrams after two treatments

Your doctor is monitoring for renal toxicity, CBC and hematologic responses.

Schedule of treatments:

  • First treatment cycle is scheduled daily for seven days over the next four weeks.
  • Subsequent cycles are scheduled after two cycles with increase dosages.

At this stage of treatment, your doctor continues to check the first cycle health reports, including:

  • Change in condition from starting the treatment
  • Any toxicity
  • Mild vs. harmful side effects


A minimum of four to six cycles is the normal duration of treatment' frequency and dosage may change depending on the patient's response, and the medicine's affect to stop the disorder.

In some cases, the cycle schedule is interrupted' in the event the patient's blood count is low, a break in treatment may be necessary for your body's defence functions to regain strength. Should the patient experience severe side effects preventing treatment, a delay in treatment happens.

Patients with impaired renal functions may experience higher levels of risk of toxic reactions due to kidney malfunctions failing to extract waste from blood and excessive body fluids. Studies show elderly patients are more likely to have decreased renal function and azacitidine doses may need to be to lower. Attention and observation of renal functions is critical for patients experiencing this side effect during treatment.

Do your best to keep all the appointments with your doctor and the laboratory. The lab results help your doctor monitor your body's response to azacitidine and the status of the condition.


Drug interactions change the risks of all health conditions. For this reason, it's critical to understand the potential reactions between your body and azacitidine. You and your doctor need to weigh the good against the bad to develop the best approach in treatment for you. The more information you share with your doctor about your past and current health situation will help with recovery.

There will always be precautions when dealing with human health conditions and introducing chemical compounds as treatment solutions. Most medicines work well together, but there are instances when health conditions such as allergies or genetics change how medicines react to each other ' affecting the treatment.

For most of us, we forget about the other drugs in our daily routines' over-the-counter medicines and health supplements, including herbal remedies, have their own unique response when a new compound enters the body.

Lifestyle routines include alcohol consumption and tobacco ' each of these contains contents that are classified as drugs, which could have harmful reactions when combined with azacitidine.

Some health conditions are inherited, we can't change them and so we learn to manage our lives around them. Allergies are sometimes passed on to the next generation, or we develop sensitives to foods, medicines, dyes or animals as children. Each can change how your body accepts or denies treatment' your doctor is ready to adjust the dose if any of these traits are subjective to interacting with treatment medicines.

As we age, we each develop various health ailments limiting the effectiveness of azacitidine. If you are older and have kidney or liver problems, your doctor needs to know, so the proper precautions can be taken before starting treatment.

If you are breastfeeding, your child depends on you for their nourishment' undergoing treatment of this drug will affect your child. Take the time to discuss the risks with your doctor if you decide to continue breastfeeding, although it is not recommended.


Warnings give alerts on potential impacts to both diagnosis and treatments, combined with the guides addressing specific drugs and drug classes' data should help patients avoid adverse effects.

  • Before starting treatment, know of the essential effectiveness of the drug.
  • Understand your participation to prevent, reduce and control the potential side effects.
  • Decisions to move forward should be based on informed and accurate information.

It's critical to keep your regular visits with your doctor to make sure the medicine is working. Blood tests are necessary to watch for low white blood cell counts, and low platelet counts. This health problem can lower your defence against infection or excessive bleeding.

  • Avoid any immunizations or vaccinations without your doctor's approval while under treatment with azacitidine.
  • Life threatening kidney problems have occurred when taking azacitidine.

This drug is associated with a health problem called tumor lysis syndrome (TLS). If you experience a fast or abnormal heartbeat, contact your doctor or seek medical help. Your doctor may have compatible medications to help prevent this condition.

  • If you are 65 or older ' talk with your doctor and get a second opinion before starting treatment.
  • Azacitidine has affected fertility ' you need to talk with your doctor to understand the consequences.

During treatment there are personal practices needed to ensure your safety and best health responses:

  • Be careful when brushing your teeth, using a dental floss or a toothpick' avoid force that may cause bleeding.
  • Use caution with sharp objects, razors, fingernail clippers, and makeup or haircare products.
  • Maintain personal hygiene' wash your hands to avoid coming in to contact with germs.
  • Avoid groups and individuals with colds or infections' an air borne virus or fungus can cause serious infections.
  • Avoid contact sports or situations for potential bruising or injury.
  • Azacitidine may make your skin more sensitive to sunlight' be sure to wear protective clothing when exposed to natural sunlight.

Azacitidine is known to cause congenital malformations in animals' the possibilities exist for similar reactions in unborn human fetuses. It is of extreme importance that women of childbearing age avoid pregnancy during treatment. Men are also susceptible to affecting an unborn child, so you need to take extra precaution to avoid impregnating your partner.


This medicine should not be taken if you are pregnant or planning to conceive. If you are not on some form of birth control, talk with your doctor and get a prescription' this drug will harm the unborn child.

DO NOT breastfeed while you are being treated with Azacitidine.


Although you will receive treatments at a medical facility or office location, your doctor may prescribe other medications during treatment. Be sure to keep any drug or treatment medication out of reach of children and pets.

Medicines should be kept in airtight containers to avoid exposure to heat, light or moisture. Always discard of expired or unused medications. DO NOT flush medications. Ask your doctor, local hospital or pharmacist to dispose of older or unused medications or medical supplies for you.


Azacitidine is considered an advancement in treatment' all patients are administered the drug for several consecutive days with a resting period of 21 days during each treatment cycle. Depending on the patient's response to the drug, the cycle with continue in four-week intervals. In the event blood counts drop or toxicity levels rise'a delay in the next treatment may be necessary.

Besides the seven-day dosage of azacitidine, your doctor may administer or prescribe other medicines to help reduce the side effects or increase the body's need to perform routine functions. Depending on the patient's response to treatment based on the assessment of health conditions, treatment may be extended to up to twelve cycles.

Last Reviewed:
December 23, 2017
Last Updated:
April 04, 2018
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