[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Alkylating agents](https://durgical.com/en/pharmacology/classes/alkylating-agents/) › Dacarbazine

# Dacarbazine

## Alkylating agents?

Alkylating agents

## High 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.

Updated Nov 1, 2026

Also called: DTIC

## Quick facts

**Group**
[Alkylating agents](https://durgical.com/en/pharmacology/classes/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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## 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 →](https://durgical.com/en/conditions/melanoma/)
- Hodgkin lymphoma, in combination regimens. [Hodgkin lymphoma →](https://durgical.com/en/conditions/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

### Serious (rare, important)

- Hepatic necrosis with hepatic vein thrombosis (rare, can be fatal)
- Anaphylaxis
- Severe tissue damage if extravasated
- Photosensitivity reactions (rare)

## 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.

## Memory aid

«DTIC: Dark-loving (light-sensitive), Turns into MTIC, Intensely emetic, Cutaneous melanoma.»

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/dacarbazine/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

## Connections

## Related drugs 2

- [Temozolomide](https://durgical.com/en/pharmacology/temozolomide/)
- [Procarbazine](https://durgical.com/en/pharmacology/procarbazine/)

## Related conditions 2

- [Melanoma](https://durgical.com/en/conditions/melanoma/)
- [Hodgkin lymphoma](https://durgical.com/en/conditions/hodgkin-lymphoma/)

[← Back to the class: Alkylating agents](https://durgical.com/en/pharmacology/classes/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](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0d81315c-7021-4091-b703-ad135390c936) (DailyMed (U.S. National Library of Medicine), 2026); [Dacarbazine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a682750.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01AX04) (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.

---
Source: https://durgical.com/en/pharmacology/dacarbazine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/dacarbazine/