Temozolomide 5mg Capsules
It is used to treat brain cancer.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Antineoplastic agent
Pharmacologic Class
Alkylating agent; Imidazotetrazine derivative
Pregnancy Category
D
FDA Approved
Aug 1999
DEA Schedule
Not Controlled
Overview
What is this medicine?
Temozolomide is a chemotherapy medicine used to treat certain types of brain tumors. It works by damaging the DNA of cancer cells, which helps to slow or stop their growth. It is often used along with radiation therapy.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided to you and follow the instructions closely.
Take your medication at the same time every day.
You can take your medication with or without food, but be consistent in how you take it each time. If you choose to take it with food, always take it with food. If you choose to take it on an empty stomach, always take it on an empty stomach. Taking it on an empty stomach may help prevent stomach upset.
Consider taking your medication at bedtime, as this may also help minimize stomach upset. However, consult with your doctor before making any changes to your dosage schedule.
Your doctor may prescribe other medications to be taken with this drug to help reduce side effects.
Swallow your medication whole with a full glass of water. Do not chew, break, crush, or dissolve the capsules.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
Your dosage may consist of two or more different strengths and colors of capsules.
If you vomit after taking your medication, do not take an additional dose.
Handling Your Medication
When handling your medication, take special precautions. Consult with your doctor or pharmacist for guidance on how to handle your medication safely.
Wear gloves when touching your medication.
If a capsule is opened or broken, avoid touching the contents. Do not inhale the contents of the capsule. If you accidentally touch the contents or get them in your eyes, wash your hands or eyes immediately.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided to you and follow the instructions closely.
Take your medication at the same time every day.
You can take your medication with or without food, but be consistent in how you take it each time. If you choose to take it with food, always take it with food. If you choose to take it on an empty stomach, always take it on an empty stomach. Taking it on an empty stomach may help prevent stomach upset.
Consider taking your medication at bedtime, as this may also help minimize stomach upset. However, consult with your doctor before making any changes to your dosage schedule.
Your doctor may prescribe other medications to be taken with this drug to help reduce side effects.
Swallow your medication whole with a full glass of water. Do not chew, break, crush, or dissolve the capsules.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
Your dosage may consist of two or more different strengths and colors of capsules.
If you vomit after taking your medication, do not take an additional dose.
Handling Your Medication
When handling your medication, take special precautions. Consult with your doctor or pharmacist for guidance on how to handle your medication safely.
Wear gloves when touching your medication.
If a capsule is opened or broken, avoid touching the contents. Do not inhale the contents of the capsule. If you accidentally touch the contents or get them in your eyes, wash your hands or eyes immediately.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
Lifestyle & Tips
- Take the capsules on an empty stomach, at least one hour before or two hours after a meal, preferably at bedtime to reduce nausea.
- Swallow capsules whole with a glass of water. Do NOT open, chew, or crush the capsules. If a capsule breaks, avoid contact with skin or mucous membranes. If contact occurs, wash thoroughly with soap and water.
- Wear gloves when handling the capsules.
- Store capsules at room temperature, away from moisture and heat.
- Maintain good hydration unless otherwise instructed by your doctor.
- Avoid live vaccines during treatment.
- Report any signs of infection (fever, chills, sore throat) or unusual bleeding/bruising immediately.
- Use effective contraception during treatment and for at least 6 months after for females, and for at least 3 months after for males.
Available Forms & Alternatives
Available Strengths:
- Temozolomide 100mg Capsules
- Temozolomide 5mg Capsules
- Temozolomide 5mg Capsules
- Temozolomide 250mg Capsules
- Temozolomide 20mg Capsules
- Temozolomide 180mg Capsules
- Temozolomide 140mg Capsules
- Temozolomide 20mg Capsules
- Temozolomide 100mg Capsules
- Temozolomide 140mg Capsules
- Temozolomide 180mg Capsules
- Temozolomide 250mg Capsules
- Temozolomide 250mg Capsules
Dosing & Administration
Adult Dosing
Standard Dose:
Varies significantly by indication and phase of treatment. For newly diagnosed Glioblastoma Multiforme (GBM): Concomitant phase: 75 mg/m² orally once daily for 42 days (up to 49 days) with focal radiotherapy. Adjuvant phase: 150 mg/m² orally once daily for 5 days, repeated every 28 days for 6 cycles (may increase to 200 mg/m² if tolerated). For refractory Anaplastic Astrocytoma (AA): 150 mg/m² orally once daily for 5 days, repeated every 28 days (may increase to 200 mg/m² if tolerated).
Dose Range:
75 - 200 mg
Condition-Specific Dosing:
newlyDiagnosedGBM_concomitant:
75 mg/m² orally once daily for 42 days (up to 49 days) with focal radiotherapy.
newlyDiagnosedGBM_adjuvant:
Initial: 150 mg/m² orally once daily for 5 days, repeated every 28 days for 6 cycles. Subsequent: May increase to 200 mg/m² if tolerated and ANC ≥1.5 x 10^9/L and platelet count ≥100 x 10^9/L on Day 1 of next cycle.
refractoryAA:
Initial: 150 mg/m² orally once daily for 5 days, repeated every 28 days. Subsequent: May increase to 200 mg/m² if tolerated and ANC ≥1.5 x 10^9/L and platelet count ≥100 x 10^9/L on Day 1 of next cycle.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
For children ≥3 years with newly diagnosed GBM, dosing is similar to adults (75 mg/m² daily for 42 days with radiotherapy, followed by 150-200 mg/m² for 5 days every 28 days). For refractory/recurrent high-grade glioma, dosing is often individualized based on body surface area and prior treatment, typically 150-200 mg/m² for 5 days every 28 days. Safety and efficacy in children <3 years have not been established.
Adolescent:
Dosing similar to adults based on body surface area.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment recommended.
Moderate:
No specific dose adjustment recommended.
Severe:
Use with caution; no data available for patients with severe renal impairment (CrCl <39 mL/min) or end-stage renal disease.
Dialysis:
Not available; use with caution as temozolomide is renally excreted.
Hepatic Impairment:
Mild:
No specific dose adjustment recommended.
Moderate:
No specific dose adjustment recommended.
Severe:
Use with caution; no data available for patients with severe hepatic impairment.
Pharmacology
Mechanism of Action
Temozolomide is an imidazotetrazine derivative that undergoes rapid chemical conversion at physiological pH to the active compound monomethyl triazenoimidazole carboxamide (MTIC). MTIC is the active alkylating metabolite, which methylates DNA at the O6 and N7 positions of guanine. This methylation leads to DNA damage, triggering cell cycle arrest and apoptosis, primarily in rapidly dividing cells like cancer cells.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 100%
Tmax:
0.5-1.5 hours
FoodEffect:
Food decreases Cmax by 33% and AUC by 9%, but is not considered clinically significant. However, it is generally recommended to administer on an empty stomach to minimize nausea/vomiting.
Distribution:
Vd:
0.4 L/kg
ProteinBinding:
10-15%
CnssPenetration:
Yes
Elimination:
HalfLife:
Approximately 1.8 hours
Clearance:
Not available
ExcretionRoute:
Renal (primarily as metabolites)
Unchanged:
5-10%
Pharmacodynamics
OnsetOfAction:
Rapid (due to rapid conversion to active metabolite)
PeakEffect:
Not directly applicable in terms of tumor response; peak plasma concentration of active metabolite occurs within 1-2 hours.
DurationOfAction:
Not directly applicable; DNA damage is sustained, leading to cell death over time.
Safety & Warnings
BLACK BOX WARNING
Myelosuppression: Temozolomide causes myelosuppression (thrombocytopenia and neutropenia), which may be severe and result in hospitalization and/or death. Prior to dosing, patients must have an absolute neutrophil count (ANC) ≥1.5 x 10^9/L and a platelet count ≥100 x 10^9/L. A complete blood count (CBC) must be obtained on Day 22 (21 days after the first dose) and weekly until the ANC is ≥1.5 x 10^9/L and the platelet count is ≥100 x 10^9/L. Temozolomide should not be given if ANC <1.5 x 10^9/L or platelet count <100 x 10^9/L.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Difficulty breathing, swallowing, or speaking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or discolored sputum
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Unexplained bruising or bleeding
Shortness of breath, significant weight gain, or swelling in the arms or legs
Weakness on one side of the body, difficulty speaking or thinking, balance problems, drooping on one side of the face, or blurred vision
Confusion
Mood changes
Difficulty swallowing
Loss of bladder control
Memory problems or loss
Abnormal burning, numbness, or tingling sensations
Seizures
Changes in vision
Pinpoint red spots on the skin
Breast pain
Signs of severe and potentially life-threatening liver problems, including:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Nausea or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellowing of the skin or eyes
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects, contact your doctor if they bother you or persist:
Hair loss
Headache
Dizziness, drowsiness, fatigue, or weakness
Constipation, diarrhea, stomach pain, nausea, vomiting, or decreased appetite
Difficulty sleeping
Back, muscle, or joint pain
Dry skin
Changes in taste
Weight gain
Symptoms of a common cold
* Mouth irritation or mouth sores
This list is not exhaustive. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Difficulty breathing, swallowing, or speaking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or discolored sputum
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Unexplained bruising or bleeding
Shortness of breath, significant weight gain, or swelling in the arms or legs
Weakness on one side of the body, difficulty speaking or thinking, balance problems, drooping on one side of the face, or blurred vision
Confusion
Mood changes
Difficulty swallowing
Loss of bladder control
Memory problems or loss
Abnormal burning, numbness, or tingling sensations
Seizures
Changes in vision
Pinpoint red spots on the skin
Breast pain
Signs of severe and potentially life-threatening liver problems, including:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Nausea or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellowing of the skin or eyes
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects, contact your doctor if they bother you or persist:
Hair loss
Headache
Dizziness, drowsiness, fatigue, or weakness
Constipation, diarrhea, stomach pain, nausea, vomiting, or decreased appetite
Difficulty sleeping
Back, muscle, or joint pain
Dry skin
Changes in taste
Weight gain
Symptoms of a common cold
* Mouth irritation or mouth sores
This list is not exhaustive. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Fever (100.4°F or higher) or chills
- Sore throat or other signs of infection
- Unusual bleeding or bruising
- Severe nausea or vomiting that prevents eating/drinking
- Severe diarrhea
- Extreme fatigue or weakness
- New or worsening headache
- Seizures
- Allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
- Yellowing of skin or eyes (jaundice), dark urine, or severe abdominal pain (signs of liver problems)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
A known allergy to dacarbazine.
If you have a low white blood cell count (leukopenia) or a low platelet count (thrombocytopenia).
If you are breastfeeding. It is crucial to avoid breastfeeding while taking this medication and for 1 week after the last dose.
To ensure safe treatment, it is vital to discuss the following with your doctor and pharmacist:
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
Any existing health problems that may interact with this medication.
Before making any changes to your medication regimen, including starting, stopping, or adjusting the dose of any drug, consult with your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
A known allergy to dacarbazine.
If you have a low white blood cell count (leukopenia) or a low platelet count (thrombocytopenia).
If you are breastfeeding. It is crucial to avoid breastfeeding while taking this medication and for 1 week after the last dose.
To ensure safe treatment, it is vital to discuss the following with your doctor and pharmacist:
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
Any existing health problems that may interact with this medication.
Before making any changes to your medication regimen, including starting, stopping, or adjusting the dose of any drug, consult with your doctor to confirm it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss your test results with your doctor.
Before receiving any vaccinations, consult with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you experience stomach upset, vomiting, diarrhea, or loss of appetite, consult with your doctor, as there may be ways to minimize these side effects.
This medication can cause low blood cell counts, which may lead to bleeding problems, infections, or anemia. In severe cases, low blood cell counts can be life-threatening and may require hospitalization or blood transfusions. If you have any concerns, discuss them with your doctor.
You may be more susceptible to infections due to this medication. To reduce the risk of infection, practice good hygiene by washing your hands frequently and avoid close contact with people who have infections, colds, or flu.
Additionally, you may be at a higher risk of bleeding easily. To minimize this risk, be cautious and avoid injuries. Use a soft-bristled toothbrush and an electric razor for shaving.
Rare but serious side effects of this medication include bone marrow problems and the development of secondary cancers. Discuss these risks with your doctor.
If you are 70 years or older, use this medication with caution, as you may be more prone to side effects.
This medication may affect fertility in men. Discuss this potential side effect with your doctor.
It is also important to note that this medication is present in semen. Do not donate semen while taking this medication or for 3 months after your last dose.
This medication can cause harm to an unborn baby. A pregnancy test will be required before starting treatment to confirm that you are not pregnant. If you or your partner may become pregnant, use effective birth control during treatment and for a period after the last dose, as advised by your doctor. If you or your partner becomes pregnant, notify your doctor immediately.
Before receiving any vaccinations, consult with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you experience stomach upset, vomiting, diarrhea, or loss of appetite, consult with your doctor, as there may be ways to minimize these side effects.
This medication can cause low blood cell counts, which may lead to bleeding problems, infections, or anemia. In severe cases, low blood cell counts can be life-threatening and may require hospitalization or blood transfusions. If you have any concerns, discuss them with your doctor.
You may be more susceptible to infections due to this medication. To reduce the risk of infection, practice good hygiene by washing your hands frequently and avoid close contact with people who have infections, colds, or flu.
Additionally, you may be at a higher risk of bleeding easily. To minimize this risk, be cautious and avoid injuries. Use a soft-bristled toothbrush and an electric razor for shaving.
Rare but serious side effects of this medication include bone marrow problems and the development of secondary cancers. Discuss these risks with your doctor.
If you are 70 years or older, use this medication with caution, as you may be more prone to side effects.
This medication may affect fertility in men. Discuss this potential side effect with your doctor.
It is also important to note that this medication is present in semen. Do not donate semen while taking this medication or for 3 months after your last dose.
This medication can cause harm to an unborn baby. A pregnancy test will be required before starting treatment to confirm that you are not pregnant. If you or your partner may become pregnant, use effective birth control during treatment and for a period after the last dose, as advised by your doctor. If you or your partner becomes pregnant, notify your doctor immediately.
Overdose Information
Overdose Symptoms:
- Severe myelosuppression (very low white blood cell count, platelet count)
- Severe nausea and vomiting
- Diarrhea
- Fatigue
What to Do:
There is no known antidote for temozolomide overdose. Treatment is supportive, including close monitoring of blood counts and administration of appropriate blood products or growth factors as needed. Call 1-800-222-1222 (Poison Control Center) or seek immediate medical attention.
Drug Interactions
Major Interactions
- Valproic acid: Concomitant administration of valproic acid may decrease the oral clearance of temozolomide by approximately 5%. The clinical significance of this is not fully established, but it could potentially increase temozolomide exposure and toxicity. Monitor for increased myelosuppression.
- Other myelosuppressive agents: Concurrent use with other agents that cause myelosuppression (e.g., other chemotherapeutic agents, radiation therapy) can lead to additive bone marrow suppression, increasing the risk of severe neutropenia and thrombocytopenia.
Moderate Interactions
- Phenytoin: May alter temozolomide metabolism, though specific data are limited. Monitor for altered efficacy or toxicity.
- Dexamethasone: Commonly co-administered, but may interact with other drugs. No direct significant interaction with temozolomide reported.
Monitoring
Baseline Monitoring
Complete Blood Count (CBC) with differential and platelets
Rationale: To establish baseline hematologic parameters and assess for pre-existing myelosuppression, which is a common and dose-limiting toxicity.
Timing: Prior to initiation of treatment.
Liver Function Tests (LFTs) including AST, ALT, bilirubin
Rationale: To assess baseline hepatic function, as temozolomide is metabolized in the liver and hepatic impairment may affect drug clearance.
Timing: Prior to initiation of treatment.
Renal Function Tests (Creatinine, BUN)
Rationale: To assess baseline renal function, as temozolomide and its metabolites are primarily renally excreted.
Timing: Prior to initiation of treatment.
Pneumocystis jirovecii pneumonia (PCP) prophylaxis assessment
Rationale: Patients receiving temozolomide with concomitant radiation therapy are at increased risk of PCP. Prophylaxis is recommended.
Timing: Prior to initiation of concomitant phase.
Routine Monitoring
Complete Blood Count (CBC) with differential and platelets
Frequency: Weekly during concomitant phase with radiation therapy; prior to each cycle (Day 1) during adjuvant phase; on Day 22 (or 21 days after first dose) of each cycle.
Target: ANC ≥1.5 x 10^9/L and platelet count ≥100 x 10^9/L for dose escalation or continuation.
Action Threshold: Dose reduction or delay if ANC <1.5 x 10^9/L or platelet count <100 x 10^9/L. Hold dose if ANC <1.0 x 10^9/L or platelet count <50 x 10^9/L.
Liver Function Tests (LFTs)
Frequency: Periodically, especially if abnormalities are noted or symptoms of hepatic dysfunction occur.
Target: Within normal limits or stable.
Action Threshold: Consider dose modification or discontinuation if significant elevations occur.
Renal Function Tests
Frequency: Periodically, especially if abnormalities are noted.
Target: Within normal limits or stable.
Action Threshold: Consider dose modification or discontinuation if significant deterioration occurs.
Symptom Monitoring
- Signs of myelosuppression (fever, chills, sore throat, unusual bleeding or bruising, fatigue)
- Gastrointestinal symptoms (nausea, vomiting, constipation, diarrhea)
- Neurological changes (headache, seizures, confusion, weakness)
- Skin reactions (rash, itching)
- Fatigue
- Hair loss
Special Patient Groups
Pregnancy
Temozolomide is classified as Pregnancy Category D. It can cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant during treatment and for at least 6 months after the last dose.
Trimester-Specific Risks:
First Trimester:
High risk of teratogenicity and embryofetal toxicity due to rapid cell division and organogenesis.
Second Trimester:
Risk of fetal growth restriction, myelosuppression, and other adverse effects.
Third Trimester:
Risk of fetal myelosuppression and other adverse effects.
Lactation
It is not known whether temozolomide or its metabolites are excreted in human milk. Because of the potential for serious adverse reactions in breastfed infants, breastfeeding is contraindicated during treatment with temozolomide and for at least one week after the last dose.
Infant Risk:
High risk (L5 - Contraindicated)
Pediatric Use
Safety and effectiveness in pediatric patients have not been established for all indications. For newly diagnosed GBM, efficacy has been demonstrated in children ≥3 years. For refractory/recurrent high-grade glioma, use is often off-label and individualized. Children may be at increased risk of myelosuppression and other toxicities. Close monitoring of blood counts is essential.
Geriatric Use
Elderly patients (≥70 years) may be at increased risk of myelosuppression (neutropenia and thrombocytopenia) compared to younger patients. Close monitoring of blood counts is recommended. No specific dose adjustment is required based on age alone, but individual patient tolerance and comorbidities should be considered.
Clinical Information
Clinical Pearls
- Administer temozolomide on an empty stomach (at least 1 hour before or 2 hours after a meal) to minimize nausea and vomiting, although food does not significantly affect absorption.
- Consider administering the dose at bedtime to help manage nausea and vomiting.
- Antiemetics (e.g., ondansetron) should be prescribed and taken as directed, especially during the first few cycles.
- Pneumocystis jirovecii pneumonia (PCP) prophylaxis (e.g., with trimethoprim/sulfamethoxazole) is strongly recommended for all patients receiving temozolomide with concomitant radiation therapy, and for patients receiving temozolomide monotherapy if lymphopenia is prolonged.
- Capsules must be swallowed whole. If a capsule is accidentally opened or damaged, avoid contact with skin or mucous membranes. If contact occurs, wash thoroughly with soap and water.
- Patients should be educated on the signs and symptoms of myelosuppression and instructed to report them immediately.
- Dose adjustments are primarily based on hematologic toxicity (ANC and platelet counts).
Alternative Therapies
- Radiation therapy (often used in combination with temozolomide)
- Surgery (resection of tumor)
- Targeted therapies (e.g., bevacizumab for recurrent glioblastoma)
- Tumor Treating Fields (TTFields, e.g., Optune)
- Immunotherapy (e.g., checkpoint inhibitors, though limited efficacy in glioblastoma)
Cost & Coverage
Average Cost:
Highly variable, typically several thousand dollars per cycle
Generic Available:
Yes
Insurance Coverage:
Specialty Tier (requires prior authorization and may have high co-pays)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.