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Oral hypomethylating agent + cytidine deaminase inhibitor (specialist)

Decitabine with cedazuridine

Brand names: Inqovi

Decitabine with cedazuridine is an oral fixed-dose combination used by specialists in the treatment of myelodysplastic syndromes and chronic myelomonocytic leukaemia; it is a haemato-oncology product rather than a rheumatology medicine.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Decitabine is a hypomethylating agent that inhibits DNA methyltransferase to restore expression of silenced genes, while cedazuridine inhibits cytidine deaminase in the gut and liver so that oral decitabine reaches effective systemic levels.

Prescribing in practice

  • Causes severe myelosuppression with marked neutropenia and thrombocytopenia, so blood counts must be monitored and cycles delayed or adjusted accordingly.
  • Should be swallowed whole and not crushed, and food affects absorption so administration timing relative to meals must follow the SPC.
  • A specialist oral chemotherapy; prescribe and supervise according to the SPC and local protocols.

Monitoring

Monitor full blood count before and during each cycle and watch for signs of infection or bleeding.

Counselling the patient

  • Swallow the tablet whole and follow instructions about food.
  • Seek urgent advice for fever, bruising or bleeding.
  • Attend all blood-test appointments.

Evidence & guidelines

Oral decitabine-cedazuridine provides exposure equivalent to intravenous decitabine in pivotal pharmacokinetic studies.

Reference: NICE TA evaluation; BSH; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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