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azacitidine

cytidine analogue, antimetabolite, aza-nucleoside · anticancer

cytidine analogue, antimetabolite, aza-nucleosideanticancer
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
  • AdalimumabSevereDatabaseDDInter
  • BaricitinibSevereDatabaseDDInter
  • CertolizumabSevereDatabaseDDInter
  • CladribineSevereDatabaseDDInter

Mechanism

Azacitidine enters cells via ENT1 (SLC29A1). The drug incorporates into DNA, where it becomes covalently bound to DNA methyltransferase, depleting the intracellular enzyme and leading to global demethylation of DNA, which results in tumor cell differentiation and apoptosis. At lower doses, it induces leukemic cell differentiation.

Indications

myelodysplasia (induces normalization of bone marrow and reduces transfusion requirement, improves survival)

Pharmacokinetics

Onset
not specified
Peak effect
not specified
Protein binding
not specified
Metabolism
rapid deamination by cytidine deaminase (after subcutaneous administration)

Side effects

Common
myelosuppressionmild GI symptomssevere nausea (with large intravenous doses)vomiting (with large intravenous doses)
Serious
  • myelosuppression

Drug interactions

Adalimumab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Baricitinib
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Certolizumab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Cladribine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Clozapine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Deferiprone
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Etanercept
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Fingolimod
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Golimumab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Infliximab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Leflunomide
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Measles Virus Vaccine Live Attenuated
Severe
Database

Drug interaction classified as: others

Source: DDInter

Related guidelines

Blood transfusion in obstetrics and gynaecology
FOGSI · Obstetrics & Gynaecology · 2024
Beta thalassaemia
ICMR · Hematology · 2022
Neonatal jaundice
MOHFW · Neonatology · 2021
Sickle cell disease
ASH · Haematology · 2020
Iron deficiency anaemia in pregnancy
FOGSI · Obstetrics & Gynaecology · 2017

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Sources: Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-10 · House clinical team