DACTINOMYCIN (ACTINOMYCIN D)

Anthracycline antibiotic anticancer usually used for paediatric cancers

Dosage Forms

Powder for injection

500 micrgrams

Uses

  • Gestational trophoblastic neoplasia
  • Ewing sarcoma
  • Wilms’ tumour
  • Rhabdomyosarcoma
  • Metastatic melanoma
  • Testicular carcinoma

Dose and Duration

Dose and duration will vary on tolerance of patient, size and location of neoplasm and use of other forms of therapy. Dos es may be reduced in case of concurrent or previous radiation and chemotherapy
Wilms’ tumour
45 micrograms/kg by IV as per schedule by specialist
Rhabdomyosarcoma
15 micrograms/kg by IV daily for 5 days
Ewing’s sarcoma
1.25 mg/m² by IV as per schedule by specialist
Testicular carcinoma
1 mg/m² by IV as per schedule by specialist
Gestational trophoblastic neoplasia
12 micrograms/kg by IV daily for 5 days as a single agent;

OR 500 micrograms on days 1 and 2 in combination therapy

Metastatic melanoma
As per patient’s treatment schedule by specialist

Contraindications

  • Hypersensitivity to dactinomycin

Side Effects

  • Gastrointestinal disturbances
  • Liver toxicity
  • Anaemia, agranulocytosis, leucopoenia, thrombocytopenia, neutropoenia,
  • Infections and infestations
  • Alopecia (hair loss)
  • Hypersensitivity reactions
  • Muscle pain
  • Extravasation at injection site

Interactions

  • Radiation/X-ray (increased risk of adverse effects)
  • Live vaccine (risk of systemic disease)

Pregnancy

  • Do not use

Breastfeeding

  • Discontinue breastfeeding

⚠️ Caution

  • Monitor full blood count, liver and renal function frequently
  • Irritant to skin. Avoid contact with skin
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines