Azacitidine
Say it: ay-zuh-SYE-tih-deen · Brand names: Vidaza, Onureg
Azacitidine is a medicine that helps bone marrow cells grow and work more normally and kills abnormal cells.
What it is
Azacitidine changes how genes are switched on and off in cells. This can help bone marrow make healthier blood cells. In higher amounts, it also kills abnormal cells.
Often used for
- myelodysplastic syndromes (MDS)
- chronic myelomonocytic leukemia (CMML)
- juvenile myelomonocytic leukemia (JMML)
- acute myeloid leukemia (AML), as an ongoing pill after first treatment
How you get it
Azacitidine is often given as a shot under the skin or through a vein (IV) once a day for 7 days, every 4 weeks. A pill form (Onureg) is taken at home once a day for 14 days of each 4-week cycle. It may take several cycles to work. Your schedule may be different.
Common side effects and what helps
- Nausea and vomiting. Take your anti-nausea medicine as your team tells you.
- Low blood counts, which raise your risk of infection and bleeding. Wash your hands often.
- Redness, bruising, or itching where the shot was given. A cool pack may help.
- Constipation or diarrhea. Drink fluids and tell your team if it lasts.
- Feeling tired. Rest and short walks can help.
- Fever. Check your temperature if you feel unwell.
- Poor appetite. Try small meals.
Call your care team right away if you have
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
- Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine
- Shortness of breath or chest pain
- Vomiting or diarrhea so bad you cannot keep fluids down
- Passing much less urine than usual
Before you start, tell your team
- If you are pregnant, may become pregnant, or are breastfeeding
- If you have kidney or liver problems
- If you have liver cancer or advanced liver disease
- All the medicines, vitamins, and herbal products you take
Good to know
- You will have blood tests often to check your blood counts, liver, and kidneys.
- Blood counts may get worse before they get better in the first few cycles.
- The pill and the shot are not the same and cannot be swapped for each other.
- It can harm an unborn baby. Women and men should use birth control during treatment and for a time after.
At home
- If you take the pills, swallow them whole with water at about the same time each day. Do not crush, cut, or chew them.
- Take your anti-nausea medicine before each pill, especially in the first cycles, as your team tells you.
- If you miss a dose or vomit after a dose, ask your team what to do.
- Store at room temperature in the original bottle with the drying packet.
- Caregivers should wear gloves if they touch the pills and wash hands after.
Questions to ask
- Will I get shots, an IV, or pills?
- How many cycles before we know if it is working?
- How often will I need blood tests or transfusions?
- What should I do if I get a fever?
Side effect guides
- Fatigue (tiredness)
- Nausea and vomiting
- Diarrhea
- Constipation
- Appetite loss and weight loss
- Low white blood cells and infection risk
- Low platelets and bleeding
Sources
Quick answers
- What is Azacitidine?
- Azacitidine is a medicine that helps bone marrow cells grow and work more normally and kills abnormal cells. Brand names: Vidaza, Onureg.
- What is Azacitidine used for?
- myelodysplastic syndromes (MDS); chronic myelomonocytic leukemia (CMML); juvenile myelomonocytic leukemia (JMML); acute myeloid leukemia (AML), as an ongoing pill after first treatment.
- How is Azacitidine given?
- Azacitidine is often given as a shot under the skin or through a vein (IV) once a day for 7 days, every 4 weeks. A pill form (Onureg) is taken at home once a day for 14 days of each 4-week cycle. It may take several cycles to work. Your schedule may be different.
- What are the common side effects of Azacitidine?
- Nausea and vomiting. Low blood counts, which raise your risk of infection and bleeding. Redness, bruising, or itching where the shot was given. Constipation or diarrhea. Feeling tired. Fever. Poor appetite.
- When should I call my care team while taking Azacitidine?
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills; Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine; Shortness of breath or chest pain; Vomiting or diarrhea so bad you cannot keep fluids down; Passing much less urine than usual.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.