Temozolomide

Antineoplastic - Alkylating AgentPODogsCats

Also known as: Temcad · Temodal · Temodar · TMZ

Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference

60-65 mg/m2PO· q24h· for 5 consecutive days on a monthly basis (28 days) for 4 to 6 cycles

This dose is based on body surface area (mg/m²). Convert body weight to body surface area before dosing.

Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.

Dosing by species

🌎 NA — North America🌍 EU — Europe

Dogs

Indication	Dose	Route	Frequency	Duration	Region
Lymphoma, melanoma, and gliomas	60-65 mg/m2	PO	q24h	for 5 consecutive days on a monthly basis (28 days) for 4 to 6 cycles	🌍 EU
Relapsed lymphoma	100 mg/m2	PO	q24h	for 5 consecutive days every 2 weeks	🌍 EU

Cats

Indication	Dose	Route	Frequency	Duration	Region
Not advised	Not advised	PO	—	—	🌍 EU

Not advised: Not advised based on early toxicity studies.

Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.

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Overview

Temozolomide is an oral alkylating antineoplastic agent used in veterinary oncology. Preliminary investigations have evaluated its use primarily in canine lymphoma, melanoma, and gliomas.

WARNING: Temozolomide is a potent cytotoxic drug. It should only be prepared and administered by trained personnel following strict chemotherapeutic safety and handling guidelines.

Mechanism of action

Temozolomide acts as an oral alkylating agent. It undergoes rapid chemical conversion at physiologic pH to the active compound, MTIC.

Mechanism of Action: Alkylates/methylates DNA (most often at the N-7 or O-6 positions of guanine residues) → DNA methylation → DNA damage → Cell death (apoptosis).

Safety & warnings

Contraindications

Known hypersensitivity to temozolomide
Pre-existing bone marrow suppression

Adverse effects

Myelosuppression (bone marrow suppression)
Gastrointestinal toxicity (vomiting, diarrhea, anorexia)
Lethargy
Polydipsia
Altered renal parameters
Altered hepatic parameters

Precautions

Cytotoxic Handling: Must be handled with extreme care by trained personnel. Pregnant women should not handle this drug.

Use with caution in patients with reduced hepatic or renal function.
Clinical Pearl: Because it is an oral chemotherapy agent, owners must be thoroughly educated on safe handling practices at home.

Monitoring

Complete Blood Count (CBC) prior to each cycle and at nadir
Renal function panel
Hepatic function panel
Clinical signs of GI toxicity or lethargy

Pharmacokinetics

Absorption

Rapidly and completely absorbed after oral administration.

Distribution

Crosses the blood-brain barrier, making it useful for CNS tumors (gliomas).

Metabolism

Undergoes spontaneous hydrolysis at physiologic pH to the active metabolite MTIC.

Elimination

Primarily excreted via the kidneys.

Overdose

Overdose may lead to severe and potentially fatal myelosuppression (pancytopenia) and severe gastrointestinal toxicity.

Treatment: There is no specific antidote. Treatment is strictly supportive, including broad-spectrum antibiotics for neutropenia, blood transfusions if necessary, and aggressive antiemetic/fluid therapy.

Available products

Formulations

Oral capsule: 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg

Human-labeled

Temcad capsules (5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg)
Temodal capsules (5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg)
Temodar capsules (5 mg, 20 mg, 100 mg, 140 mg, 180 mg, 250 mg)

Regulatory status

European Union✓ ApprovedPrescription onlyEMA

POM (Prescription Only Medicine). Human registered products used under the cascade.

United Kingdom✓ ApprovedPrescription onlyVMD