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Temonat

Temonat (Temozolomide 20/100/250 mg) — Natco oral alkylator for newly diagnosed glioblastoma multiforme. PCP prophylaxis during chemoradiation phase recommended.

Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience  · Last reviewed: May 2026

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Temonat — temozolomide 20/100/250 mg (Natco Pharma). Oral DNA-alkylating agent — first-line chemotherapy for glioblastoma multiforme (with concurrent radiotherapy then adjuvant), anaplastic astrocytoma, melanoma (off-label/historical). Crosses the blood-brain barrier.

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⚠️ Specialist-supervised cancer therapy — this medication is started, monitored, and stopped by an oncologist or haematologist. Dosing depends on tumour type, stage, body surface area, organ function, and concomitant therapy. Self-treatment is not appropriate; the information below is educational and supports informed conversations with your specialist.

Myelosuppression + PCP prophylaxis
Cumulative myelosuppression (especially thrombocytopenia and lymphopenia). Mandatory weekly FBC. Lymphopenia + concurrent radiotherapy creates infection risk — Pneumocystis jirovecii pneumonia (PCP) prophylaxis (cotrimoxazole or atovaquone) is recommended during the chemoradiation phase.

Frequently Asked Questions

Standard schedule?

Stupp protocol: 75 mg/m²/day during 6 weeks of radiotherapy, then 4-week break, then adjuvant 150-200 mg/m² × 5 days every 28 days for 6 cycles. Newer schedules (extended adjuvant, dose-dense) are used in selected cases.

Take with food?

Empty stomach (1 hour before food or 2 hours after) on the same schedule each day. Antiemetic prophylaxis (5-HT3 antagonist) is standard.

Common side effects?

Nausea/vomiting (controlled by antiemetics), fatigue, lymphopenia, thrombocytopenia, headache, alopecia (with radiotherapy), constipation.

MGMT methylation status?

MGMT promoter methylation predicts greater benefit from temozolomide. Test all newly diagnosed glioblastomas. Methylated tumours have median survival ~22 months on Stupp regimen vs ~12 months unmethylated.

PCP prophylaxis — why?

Prolonged lymphopenia + concurrent radiotherapy creates risk of opportunistic infection, particularly Pneumocystis jirovecii pneumonia. Cotrimoxazole 480 mg three times weekly during the chemoradiation phase is standard.

Pregnancy?

Strongly contraindicated — teratogenic. Effective contraception during and for at least 6 months after for both partners.

Drug interactions?

Few significant. Valproate may modestly affect levels. Antiemetics (granisetron, ondansetron) routinely used.

What if I miss a dose?

Skip the missed dose; resume normal schedule next day. Notify oncology team.

Long-term complications?

Cumulative myelosuppression and small risk of secondary malignancy (myelodysplasia, AML) after years of cumulative therapy.

What about second-line?

On glioblastoma progression, options include bevacizumab, lomustine, re-irradiation, or clinical trials. No standard-of-care second-line — all decisions specialist-led.

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Medical Disclaimer: Cancer therapy is highly individualised. Specific drug, dose, schedule, monitoring, and supportive care must be determined by a qualified oncologist or haematologist based on tumour biology, staging, comorbidities, and goals of care. This information is educational; it does not substitute for professional medical advice.

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Strength

20 mg, 100 mg, 250 mg

Quantity

5 Capsule/s, 10 Capsule/s, 15 Capsule/s, 30 Capsule/s, 45 Capsule/s

Pharma Form

Capsule/s

Manufacturer

Natco Pharma

Treatment

Brain tumor

Generic Brand

Temozolomide

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