DACTINOM 0.5MG

Dactinomycin 0.5 mg
Net Qty- 1 Injection
Shelf-Life- 2 Years

Dactinom (Dactinomycin 0.5 mg) is a chemotherapy drug classified as an antineoplastic antibiotic. It is used to treat various cancers by inhibiting DNA synthesis and causing tumor cell death.

USE

Dactinomycin is FDA-approved and used in combination with other therapies for:

  1. Wilms Tumor:

    • Often used as part of a multi-agent regimen in pediatric patients.

  2. Rhabdomyosarcoma:

    • Primarily in pediatric patients, combined with surgery and/or radiation.

  3. Ewing Sarcoma:

    • Frequently combined with other chemotherapeutic agents.

  4. Gestational Trophoblastic Neoplasia (GTN):

    • Used in high-risk or refractory cases.

  5. Metastatic Nonseminomatous Testicular Cancer:

    • As part of salvage therapy regimens.

  6. Other Off-Label Uses:

    • May be used for desmoid tumors or Kaposi sarcoma in selected cases.

Mechanism
of Action

Dactinomycin intercalates into DNA, interfering with RNA synthesis and causing DNA strand breaks. This inhibits tumor growth by:

  1. Blocking Transcription:

    • Prevents RNA polymerase from functioning.

  2. Inducing Apoptosis:

    • DNA damage triggers programmed cell death in rapidly dividing tumor cells.

Dosage and Administration

Typical Doses:
  • 0.015 mg/kg/day or 400-600 mcg/m²/day for 5 days, repeated every 3-4 weeks depending on the cancer type.
Preparation:
  • Reconstitute with sterile water for injection.
  • Use immediately after reconstitution; store as per stability guidelines.
Administration:
  • Intravenous (IV) Only: Administer via slow IV push or infusion to minimize toxicity.
  • Avoid extravasation, as it can cause severe tissue damage.

Common Side Effects

Frequent (>20%):
  1. Gastrointestinal:
    • Nausea, vomiting, stomatitis, and diarrhea.
  2. Hematologic:
    • Myelosuppression (neutropenia, anemia, thrombocytopenia).
  3. Fatigue and Weakness:
    • Generalized but reversible.
Mild to Moderate:
  • Skin rash, alopecia, or fever.
Severe or Rare Side Effects
  1. Tissue Necrosis:
    • Extravasation can lead to severe local tissue injury and necrosis.
  2. Hepatotoxicity:
    • Elevated liver enzymes or veno-occlusive disease, particularly in children.
  3. Severe Myelosuppression:
    • Can result in life-threatening infections or bleeding.
  4. Secondary Malignancies:
    • Rare but possible long-term risk.
  5. Hypersensitivity Reactions:
    • Rash, urticaria, or anaphylaxis in rare cases.

Monitoring

Complete Blood Count (CBC):

  • Monitor frequently during and after treatment cycles.

Liver Function Tests (LFTs):

  • Assess for hepatotoxicity.

Renal Function:

  • Check serum creatinine and BUN.

Injection Site:

  • Inspect for extravasation or local reactions.

Precautions

Pregnancy and Breastfeeding:

  • Contraindicated due to teratogenicity and mutagenicity.

Handling Precautions:

  • Use appropriate protective equipment; dactinomycin is a vesicant.

Extravasation:

  • Immediate interventions include stopping infusion and applying antidotes like dimethyl sulfoxide (DMSO).

Drug Interactions

Hepatotoxic Drugs:

  • Concurrent use (e.g., methotrexate) may exacerbate liver damage.

Radiation Therapy:

  • Increased risk of radiation recall reactions (severe skin or tissue inflammation at irradiated sites).

Clinical Effectiveness

Wilms Tumor:
  • Improves survival rates when combined with surgery, radiation, and other chemotherapies.
Rhabdomyosarcoma:
  • Effective as part of multi-agent therapy in achieving remission.
Gestational Trophoblastic Neoplasia (GTN):
  • Dactinomycin is used in cases resistant to methotrexate or as a second-line therapy.

Tips for Patients

Hydration:
  • Maintain adequate fluid intake to reduce nephrotoxicity risk.
Infection Prevention:
  • Avoid crowds and practice good hygiene due to neutropenia risk.
Skin Protection:
  • Report redness or pain near IV infusion sites immediately.
Symptom Monitoring:
  • Notify your doctor about unusual bleeding, persistent fever, or severe fatigue.