Comprehensive medication guide to Temodar including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$600+ copay per cycle depending on plan tier and deductible status; most commercial insurers place temozolomide on a specialty drug tier (Tier 4–5) with coinsurance of 20–30%. Medicare Part D covers oral temozolomide; prior authorization is required by most plans.
Estimated Cash Pricing
$113–$600+ per 5-day cycle for generic temozolomide depending on dose strength; brand Temodar retails at $3,400+ per cycle. With GoodRx or SingleCare coupons, generic temozolomide can be found for as low as approximately $113 at certain pharmacies.
Medfinder Findability Score
60/100
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Temodar is the brand name for temozolomide, an oral alkylating chemotherapy agent first approved by the FDA in August 1999. It is manufactured by Merck Sharp & Dohme LLC and is available in capsule strengths of 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, and 250 mg, as well as a 100 mg intravenous formulation for patients who cannot swallow capsules.
Temodar is FDA-approved for adults with newly diagnosed glioblastoma multiforme (GBM) — the most aggressive primary brain tumor — and for newly diagnosed and refractory anaplastic astrocytoma. It is also used off-label for other brain tumor types. In September 2023, the FDA updated Temodar's labeling under Project Renewal, a program that modernizes labeling for older, commonly prescribed oncology drugs.
Generic temozolomide is widely available from multiple manufacturers including Teva, Sun Pharma, Dr. Reddy's, and Amneal, and is therapeutically equivalent to brand Temodar at a significantly lower cost.
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Temozolomide is a prodrug — it is not active in the form you take it. After oral or IV administration, it is rapidly absorbed and, at physiologic pH, undergoes spontaneous nonenzymatic conversion to its active metabolite, MTIC (5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide). This conversion does not require liver enzymes.
MTIC alkylates (methylates) DNA primarily at the O6 and N7 positions of guanine. This causes DNA double-strand breaks that the cancer cell cannot repair, triggering programmed cell death (apoptosis). Temozolomide crosses the blood-brain barrier efficiently — a key advantage for treating brain tumors.
A critical determinant of temozolomide's efficacy is MGMT methylation status. Tumors that have a methylated MGMT promoter lack the DNA repair enzyme MGMT, making them unable to reverse temozolomide's DNA damage — and therefore more responsive to treatment. Patients with MGMT-methylated GBM have significantly better outcomes with the Stupp protocol (concurrent chemoradiation + maintenance temozolomide).
5 mg — capsule
Oral capsule — used in combination with other strengths to achieve exact BSA-based dose
20 mg — capsule
Oral capsule — used in combination with other strengths
100 mg — capsule
Oral capsule — most commonly dispensed strength
140 mg — capsule
Oral capsule
180 mg — capsule
Oral capsule
250 mg — capsule
Oral capsule — highest available single-capsule strength
100 mg — injection
Lyophilized powder for IV infusion (90-minute infusion); used when patient cannot swallow capsules
Oral generic temozolomide is generally available in 2026 through specialty pharmacy channels, with multiple generic manufacturers providing supply redundancy. However, Temodar is a specialty chemotherapy medication and is not routinely stocked at standard retail pharmacies like CVS, Walgreens, or Walmart. It is typically dispensed through oncology clinic pharmacies or designated specialty pharmacies such as Accredo, CVS Specialty, Walgreens Specialty, or BioPlus.
The IV formulation of temozolomide has experienced periodic institutional shortages. Patients needing IV temozolomide should confirm availability with their treatment center before each cycle. Insurance prior authorization is required by most plans and can add 2–5 business days to the fill timeline. Submitting prescriptions 7–10 days before each treatment cycle is strongly recommended.
If you're having difficulty locating your temozolomide prescription, medfinder contacts pharmacies near you to find which ones can fill your specific prescription and texts you the results — eliminating the need to call dozens of pharmacies yourself.
Temodar (temozolomide) is not a DEA-controlled substance, so there are no federal scheduling restrictions on prescribing. However, because it is a complex chemotherapy drug requiring body surface area dosing and mandatory blood count monitoring, it is always prescribed by qualified oncology specialists. Primary care physicians generally do not prescribe temozolomide independently.
Providers who commonly prescribe Temodar include:
Neuro-oncologists (primary prescribers for GBM and anaplastic astrocytoma)
Medical oncologists (in settings without neuro-oncology subspecialty)
Radiation oncologists (co-managing concurrent chemoradiation)
Telehealth availability: many major cancer centers including Mayo Clinic, UCSF, MD Anderson, Cleveland Clinic, and Memorial Sloan Kettering offer neuro-oncology telehealth consultations. Local oncologists can then manage prescriptions in coordination with the remote specialist, making care accessible to patients in rural or underserved areas.
No. Temodar (temozolomide) is not a DEA-controlled substance and has no federal drug scheduling classification. It does not have the prescription refill restrictions, pharmacy lock-in requirements, or quantity limitations that apply to Schedule II–V controlled substances such as opioids or stimulants.
However, because Temodar is a chemotherapy drug with significant toxicity risks and a complex dosing protocol (body surface area-based dosing), it is always prescribed and managed by a qualified oncology provider — typically a neuro-oncologist or medical oncologist. Prescription access is therefore tightly controlled by clinical context rather than DEA scheduling. Most insurance plans also require prior authorization before covering temozolomide.
Common side effects experienced during Temodar treatment include:
Nausea and vomiting
Fatigue and tiredness
Hair loss (alopecia) — typically reversible after treatment
Constipation
Headache
Decreased appetite
Dizziness and coordination problems
Myelosuppression: dangerously low blood cell counts (neutropenia, thrombocytopenia, aplastic anemia) — monitor CBC before every cycle
Hepatotoxicity: liver enzyme elevations and rare fatal liver damage — periodic LFT monitoring required
Opportunistic infections: including Pneumocystis pneumonia (PCP) — fever of 100.4°F or higher is a medical emergency
Pulmonary toxicity: rare interstitial pneumonitis and pulmonary fibrosis
Severe allergic reactions: anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis
Fetal harm: Category D — contraindicated in pregnancy; use contraception for 6 months after last dose
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Lomustine (CeeNU/CCNU)
Oral nitrosourea alkylating agent; first-line for MGMT-methylated GBM in combination with temozolomide (CCNU/TMZ); also used as monotherapy in recurrent GBM. Given every 6 weeks.
Bevacizumab (Avastin)
Anti-VEGF monoclonal antibody; FDA-approved for progressive glioblastoma. Given IV every 2 weeks. Improves progression-free survival but has not consistently shown overall survival benefit in GBM.
Procarbazine/PCV
Oral alkylating agent used in PCV regimen (procarbazine + lomustine + vincristine); preferred for 1p/19q co-deleted anaplastic oligodendroglioma; may also be used for certain anaplastic astrocytomas.
Carmustine/BCNU (BiCNU, Gliadel)
Nitrosourea alkylating agent available as IV infusion (BiCNU) or as implantable polymer wafer (Gliadel) placed in surgical cavity during resection. Used for high-grade gliomas including GBM.
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Valproic acid (Depakote)
moderateDecreases clearance of temozolomide by approximately 5%, potentially increasing exposure and toxicity risk. Monitor for enhanced myelosuppression. Many GBM patients take valproic acid for seizure prevention — consider switching to levetiracetam (Keppra) which has fewer interactions.
Live vaccines
majorContraindicated during temozolomide therapy. Immunosuppression from chemotherapy can cause live attenuated vaccines to cause actual infection. Avoid MMR, varicella, yellow fever, and nasal flu vaccines during treatment.
Dacarbazine (DTIC)
majorAbsolute contraindication: both drugs metabolize to MTIC. Patients with prior hypersensitivity to dacarbazine are at risk of cross-reactive hypersensitivity to temozolomide.
Carbamazepine, phenytoin, sulfamethoxazole/trimethoprim
moderateThese drugs are independently associated with aplastic anemia, complicating assessment of bone marrow toxicity during temozolomide treatment. Report concomitant use to oncologist.
Immunosuppressants/corticosteroids
moderateAdditive immunosuppression increases risk of serious infections including Pneumocystis pneumonia. Dexamethasone is commonly co-prescribed for brain edema — PCP prophylaxis is recommended during concurrent chemoradiation.
Ranitidine
minorNo clinically significant pharmacokinetic interaction with temozolomide. Cmax and AUC values unchanged in clinical studies.
Temodar (temozolomide) has been the cornerstone of glioblastoma treatment for over 25 years. The Stupp protocol — concurrent temozolomide + radiation followed by maintenance temozolomide — transformed GBM care when published in 2005 and remains the global standard. While GBM outcomes remain challenging, temozolomide continues to extend survival and quality of life for many patients.
The availability of generic temozolomide from multiple manufacturers has improved access and reduced costs. For most patients, generic temozolomide is clinically equivalent to brand Temodar and significantly more affordable. Patients should work closely with their oncology team and specialty pharmacy to ensure their prescription is secured well in advance of each treatment cycle.
If you're having trouble locating your temozolomide prescription at a pharmacy near you, medfinder can help. Simply provide your medication name, dosage, and ZIP code, and medfinder contacts pharmacies in your area to find out which ones can fill your prescription — sending you the results by text. It's a simple tool for an often complicated process.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
Real-time availability
Medfinder is actively checking pharmacy inventory for Temodar. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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