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How does this medication work? What will it do for me?

Dactinomycin belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the family of antineoplastics called actinomycins. Dactinomycin causes the death of cancer cells by interfering with their growth and reproduction.

Dactinomycin is used to treat certain types of cancer. It is used alone or in combination with other cancer therapies to treat gestational trophoblastic neoplasia (a type of cancer that occurs in the uterus). It is also used in combination with other cancer therapies to treat childhood rhabdomyosarcoma, Ewing’s sarcoma, and Wilms’ tumour.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each vial contains lyophilized, amorphous yellow dactinomycin powder 500 µg and mannitol 20 mg. Forms a clear gold-coloured solution on reconstitution.

Who should not take this medication?

Do not use dactinomycin if you:

  • are allergic to dactinomycin or any ingredients of the medication
  • have an active infection of chickenpox or herpes zoster

How should I use this medication?

The recommended dose and dosing schedule of dactinomycin varies according to the specific type of cancer being treated, the response to therapy, and the other medications or treatments being used. The dose administered is also based on body size.

This medication is usually injected into a vein through a specially prepared site on your skin. It is always given under the supervision of a doctor. Very careful handling of this medication is required. It is always administered in a hospital or similar setting with access to sterile equipment for preparation.

As well as interfering with the genetic material DNA of cancer cells, dactinomycin can interfere with some of your normal cells. This can cause a number of side effects such as hair loss and mouth sores.

Dactinomycin often causes nausea and vomiting, but it is important to keep using this medication even if you feel ill. Your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that dactinomycin be given exactly as recommended by your doctor. If you miss an appointment to receive this medication, contact your doctor as soon as possible to reschedule your appointment.

This medication is stored at room temperature and protected from light and humidity.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use dactinomycin if you:

  • are allergic to dactinomycin or any ingredients of the medication
  • have an active infection of chickenpox or herpes zoster

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who used this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

Important note: Side effects (except for nausea and vomiting) do not usually become apparent until 2 to 4 days after a course of therapy and may not reach their peak for an additional 1 to 2 weeks.

  • constipation
  • fatigue
  • nausea and vomiting
  • skin darkening or redness of areas where radiation was given
  • skin rash or acne
  • temporary loss of hair

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • diarrhea
  • difficulty swallowing
  • pain, redness, or swelling at the place of injection
  • signs of infection such as fever higher than 38°C (100°F), chills, sweating, sore throat, coughing, painful urination, unusual vaginal itching or discharge, or redness or swelling around a cut, wound, or catheter site
  • sores in mouth
  • stomach pain
  • symptoms of anemia such as fatigue, weakness, or shortness of breath
  • symptoms of liver problems such as yellow eyes or skin, swelling or enlargement of the abdomen, dark urine, pale stools, nausea, or vomiting
  • unusual bleeding (e.g., black or tarry stools or blood in the urine) or bruising
  • weight loss

Stop using the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a severe allergic reaction such as hives, difficulty breathing, or swelling of the mouth or throat
  • symptoms of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting properly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won’t stop bleeding.

Fertility: There is little information about whether this medication causes infertility. However, other anticancer medications may cause infertility. Therefore, this medication may cause infertility. Discuss any concerns about infertility with your doctor.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who are sick, especially those with contagious infections, and tell your doctor if you begin to notice signs of an infection, such as fever or chills.

Liver problems: If you have moderate to severe liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Secondary cancers: Anticancer medications such as dactinomycin may cause other types of cancer to develop, including leukemia. Talk to your doctor if you have concerns about this.

Vaccinations: You should not receive live vaccines while receiving dactinomycin.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Effective birth control should be practiced while using dactinomycin. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if dactinomycin passes into breast milk. Women should not breast-feed while receiving dactinomycin treatment due to risk of potential harm to the infant. Talk to your doctor.

Children: This medication should be given to infants only over the age of 6 months.

What other drugs could interact with this medication?

There may be an interaction between dactinomycin and any of the following:

  • 5-aminosalicylic medications (e.g., mesalamine, olsalazine, sulfasalazine)
  • BCG
  • cladribine
  • clozapine
  • deferiprone
  • denosumab
  • echinacea
  • leflunomide
  • natalizumab
  • ocrelizumab
  • ofatumumab
  • pimecrolimus
  • sphingosine 1-phosphate (S1P) receptor modulators (e.g., fingolimod, ponesimod, siponimod)
  • tacrolimus
  • tofacitinib
  • upadacitinib
  • vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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Last Updated: 18/07/2024