Dactinomycin Actinomycin D

Dactinomycin Actinomycin D Brand Name– Cosmegen

What is Dactinomycin Actinomycin D

Dactinomycin is a cytotoxic antitumor antibiotic that is indicated for the treatment of adult and pediatric patients with Wilms tumor, rhabdomyosarcoma, Ewing sarcoma, and testicular cancer in combination with chemotherapy.

It is also indicated in postmenarchal patients with gestational trophoblastic neoplasia and in adult patients with locally recurrent or locoregional solid malignancies as a component of palliative or adjunctive regional perfusion.

Hepatotoxicity has been reported with dactinomycin therapy, including fatal sinusoidal obstruction syndrome previously termed veno-occlusive disease.

Indications

  1. Kaposi’s sarcoma
  2. malignant melanoma
  3. osteogenic sarcoma
  4. rhabdomyosarcoma
  5. testicular cancer
  6. trophoblastic disease
  7. Wilms’ tumor

For the treatment of gestational trophoblastic disease

for the treatment of nonmetastatic or low-risk metastatic gestational trophoblastic disease, as a single-agent

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. agranulocytosis
  4. alopecia
  5. anemia
  6. anorexia
  7. aplastic anemia
  8. ascites
  9. bleeding
  10. cheilitis
  11. diarrhea
  12. disseminated intravascular coagulation (DIC)
  13. dysphagia
  14. edema
  15. elevated hepatic enzymes
  16. erythema
  17. erythema multiforme
  18. esophagitis
  19. fatigue
  20. fever
  21. growth inhibition
  22. hepatic failure
  23. hepatitis
  24. hepatomegaly
  25. hyperbilirubinemia
  26. hypocalcemia
  27. impaired wound healing
  28. infection
  29. injection site reaction
  30. lethargy
  31. leukemia
  32. leukopenia
  33. malaise
  34. myalgia
  35. nausea
  36. nephrotoxicity
  37. neutropenia
  38. new primary malignancy
  39. oral ulceration
  40. pancytopenia
  41. peptic ulcer
  42. peripheral neuropathy
  43. pharyngitis
  44. phlebitis
  45. pneumonitis
  46. pneumothorax
  47. proctitis
  48. radiation recall reaction
  49. rash
  50. renal failure (unspecified)
  51. sinusoidal obstruction syndrome (SOS)
  52. skin hyperpigmentation
  53. skin ulcer
  54. Stevens-Johnson syndrome
  55. stomatitis
  56. thrombocytopenia
  57. thrombosis
  58. tissue necrosis
  59. toxic epidermal necrolysis
  60. tumor lysis syndrome (TLS)
  61. veno-occlusive disease (VOD)
  62. visual impairment
  63. vomiting
  64. weight gain

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum creatinine/BUN
  • serum electrolytes
  • weight

Contraindications

  • accidental exposure
  • anemia
  • bone marrow suppression
  • breast-feeding
  • children
  • contraception requirements
  • extravasation
  • geriatric
  • hepatotoxicity
  • herpes infection
  • infants
  • infection
  • laboratory test interference
  • male-mediated teratogenicity
  • nephrotoxicity
  • neutropenia
  • new primary malignancy
  • ocular exposure
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • reproductive risk
  • requires an experienced clinician
  • serious rash
  • sinusoidal obstruction syndrome (SOS)
  • thrombocytopenia
  • vaccination
  • veno-occlusive disease (VOD)

Interactions

  • Alpha interferons
  • Amlodipine; Celecoxib
  • Antithymocyte Globulin
  • Azelastine; Fluticasone
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Beclomethasone
  • Betamethasone
  • Budesonide
  • Budesonide; Formoterol
  • Carbamazepine
  • Celecoxib
  • Ciclesonide
  • Clozapine
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Deflazacort
  • Dexamethasone
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Fludrocortisone
  • Flunisolide
  • Flurbiprofen
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Hydrocodone; Ibuprofen
  • Hydrocortisone
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Influenza Virus Vaccine
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Intranasal Influenza Vaccine
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Methylprednisolone
  • Mometasone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Penicillamine
  • Piroxicam
  • Prednisolone
  • Prednisone
  • Rofecoxib
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Sulindac
  • Tolmetin
  • Triamcinolone
  • Tuberculin Purified Protein Derivative, PPD
  • Typhoid Vaccine
  • Valdecoxib
  • Varicella-Zoster Virus Vaccine, Live
  • Yellow Fever Vaccine, Live
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