Dactinomycin   

Brand name: Cosmegen 

Generic name: Dactinomycin 

Therapeutic Class: alkylating agent  

Manufacturer / Distributor:  MSD-Chibret 

Availability:  Dactinomycin is available by prescription only  

Dosage form: Dactinomycin is given through a vein 

Indications: Dactinomycin is used, alone or in association with other anticancer drugs, to treat the following cancers:  

• Ewing's sarcoma 
• testicular cancer 
• melanoma  
• uterine cancer 
• Wilms' tumor 
• rhabdomyosarcoma 
• gestational trophoblastic disease 
• neuroblastoma  
• retinoblastoma  
• Kaposi's sarcoma 
• Soft tissue sarcoma.

Dactinomycin is sometimes used to treat other medical conditions not mentioned in this article; talk to your pharmacist or doctor for more information.  

Dosage: Dactinomycin is usually injected into a vein through an intravenous site on the skin, which beforehand was sterilized. The drug can be administered alone or in combination with other antineoplastic agents (also called cancer chemotherapy drugs, cytotoxic drugs). The dose recommended by your doctor varies depending on your health in general, other drugs you are taking, type of cancer you have, and especially your weight and height. The reactions of your body to the treatment can obligate your health care provider to modify or stop the treatment. 

Dactinomycin is usually administered in hospital or a center having sterilization equipment available for its preparation. The drug must be prepared and administered by medical specialists in oncology or hematology or nurses experienced in oncology. Although administered into a vein, the drug can leak into surrounding tissue, cause health issues; special monitoring during the treatment is necessary.  

 Overdose: Dactinomycin is administered in hospital by professionals; the risk of overdose is very low. However, accidental overdose or administrative mistake can happen. Dactinomycin overdose can cause exaggerated immunosuppression (life threatening low immune defense), and lead to severe or fatal infections. There is no specific treatment for Dactinomycin overdose. The treatment is symptomatic and close monitoring to avoid major complications. 

 Missing dose: the fact that Dactinomycin is administered in hospital by professional, it is very difficult to miss any dose if you are present at your doctor’s appointment. If for some reasons you cannot go to the hospital for the treatment, contact your health care provider before the date schedule for the injection.  

Contraindication: Dactinomycin is not recommended, or should be used with precaution in the following conditions: 

• Pregnancy 
• breastfeeding  
• bone marrow failure  
• during or shortly after chickenpox or shingles 
• Allergy to Dactinomycin or one of its ingredients.  

Mechanism of action (MOA): Dactinomycin slows or stops the growth of cancer cells in your body by modifying the structure of their DNA. 

Interactions: Some substances may interfere with the healing power of Dactinomycin, or amplify its toxic effects. You should not take any prescription or non prescription (including aspirin and vitamins) drugs during the treatment with Dactinomycin without first consulting your doctor or pharmacist. Dactinomycin should not be associated with vaccine against yellow fever, phenytoin, or live attenuated vaccines. If Dactinomycin is associated with radiation therapy, increased surveillance is strongly recommended.  

Side effects:  by attacking the cancer cells, Dactinomycin also attacks normal cells, which can cause various side effects in most patients. Common Dactinomycin side effects include:   

• mouth blistering  
• temporary hair loss  
• nausea and vomiting 
• decreased appetite
• weight loss  
• abdominal pain and diarrhea 
• difficulty swallowing 
• blistering skin 
• skin irritation  
• Skin rash.  

Dactinomycin can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:  

• chills 
• Seizures  
• fever, which can be accompanied with a persistent cough 
• shortness of breath 
• breathing difficulty  
• unusual bruising or bleeding 
• dizziness or/and faintness
• yellowing of the skin or eyes 
• swelling of your feet or ankles 
• Swelling and pain at the injection site.  

References: 

nlm.nih.gov