Oral cedazuridine 100 mg with decitabine 35 mg is given as a single pill. Decitabine is a nucleoside inhibitor that is incorporated into DNA after phosphorylation to 5-AZA-dCTP. Once incorporated into DNA, it inhibits DNMT, causing hypomethylation and altered gene expression, which is hypothesized to affect cellular differentiation and apoptosis in the treatment of MDS and AML. It may also cause abnormal DNA synthesis and replication, therefore decreasing cell proliferation and inducing apoptosis. Cedazuridine is a CDA inhibitor that prevents the degradation of decitabine when taken orally. 5-AZA-dC, 5-aza-2′deoxycytidine; 5-AZA-dCMP, 5-aza-2′deoxycytidine monophosphate; 5-AZA-dCDP, 5-aza-2′deoxycytidine diphosphate; 5-AZA-dU, deazuridine.