Dacarbazine
Alkylating agents
Alkylating agentsHigh alert
An error with this medicine can cause serious harm: double checks and protocols are used.
An intravenous triazene that the liver turns into the methylating agent MTIC. Used for metastatic melanoma and in Hodgkin lymphoma regimens; very emetogenic.
Also called: DTIC
Quick facts
- Group
- Alkylating agents
- Target
- DNA (guanine), methylated by MTIC
- Used for
- Metastatic malignant melanoma · Hodgkin lymphoma
- Key effects
- Severe nausea and vomiting · Flu-like syndrome
- Monitor
- Blood counts · Liver tests and signs of liver injury
- ATC
- L01AX04
No doses: the clinician sets them by the current guideline.
Mechanism of action
Dacarbazine is activated in the liver by N-demethylation to MTIC, the same methylating compound that temozolomide forms without enzymes. MTIC transfers a methyl group to guanine in DNA. The label lists three proposed actions: alkylation, inhibition of DNA synthesis as a purine analogue, and interaction with sulfhydryl groups.
- The liver demethylates dacarbazine to MTIC
- MTIC methylates guanine in DNA
- Damaged DNA triggers cell death
Indications
- Metastatic malignant melanoma. Melanoma →
- Hodgkin lymphoma, in combination regimens. Hodgkin lymphoma →
Adverse effects
Common
- Severe nausea and vomiting with the first doses
- Flu-like syndrome: fever, myalgia, malaise
- Myelosuppression (leukopenia, thrombocytopenia)
- Pain and burning along the vein
Contraindications
- Previous hypersensitivity to dacarbazine
Key interactions
- Temozolomide
- Same active metabolite: a serious reaction to one contraindicates the other.
- Other myelosuppressive drugs
- Additive bone marrow suppression.
What is monitored
- Blood counts
- Liver tests and signs of liver injury
- Infusion site
Administration and safety
- Protected from light during storage and infusion.
- Intravenous only; the site is watched closely because extravasation causes tissue damage and severe pain.
- Strong antiemetic prophylaxis before each dose.
Pregnancy and breastfeeding
Can cause fetal harm; pregnancy is avoided during treatment.
Nursing care
- Give antiemetics before the dose and assess nausea afterwards.
- Watch the vein for pain or burning; stop and assess at once if extravasation is suspected.
- Teaching: flu-like symptoms may follow; avoid strong sunlight; report yellow skin or abdominal pain.
Pharmacokinetics
- Absorption
- Intravenous only; it is light-sensitive.
- Distribution
- Volume of distribution larger than body water, suggesting tissue binding, possibly in the liver.
- Metabolism
- Activated in the liver; one metabolite (AIC) is excreted in the urine.
- Half-life
- Biphasic: a short initial phase and a terminal phase of a few hours.
Test yourself
Think of the answer, then tap the question to see it.
How is dacarbazine activated?
By N-demethylation in the liver to MTIC.
Which cancer is dacarbazine classically used for as a single agent?
Metastatic malignant melanoma.
Which rare but fatal liver complication can dacarbazine cause?
Hepatic necrosis with hepatic vein thrombosis.
Connections
← Back to the class: Alkylating agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - DACARBAZINE injection, powder, lyophilized, for solution (DailyMed (U.S. National Library of Medicine), 2026); Dacarbazine: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.