Dactinomycin
- Atc Codes:L01DA01
- CAS Codes:50-76-0
- PHARMGKB ID:50-76-0
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Cosmegen; Belgium: Lyovac Cosmegen; Bulgaria: Cosmegen; Estonia: Cosmegen; Finland: Cosmegen; France: Cosmegen; Germany: Lyovac-Cosmegen; Greece: Cosmegen Lyovac; Ireland: Cosmegen Lyovac; Malta: Cosmegen; Netherlands: Lyovac Cosmegen; Romania: Cosmogen Lyovac; Sweden: Cosmegen.
North America
Canada: Cosmegen; USA: Cosmegen.
Latin America
Argentina: Cosmegen; Brazil: Cosmegen; Mexico: AC-DE, Cosmegen.
Asia
Japan: Cosmegen.
Drug combinations
Chemistry
Dactinomycin: C~62~H~86~N~12~O~16~. Mw: 1255.42. (1) Actinomycin D. (2) Specific stereoisomer of N,N’-[(2-amino-4,6-dimethyl-3-oxo-3H-phenoxazine-1,9-diyl)-bis[carbonylimino(2-hydroxypropylidene)carbonyliminoisobutylidenecarbonyl-1,2-pyrrolidinediylcarbonyl(methylimino)methylenecarbonyl]]bis[N-methyl-L-valine] dilactone. CAS-50-76-0 (1964).
Pharmacologic Category
Antineoplastic Agents; Cytotoxic Antibiotics and Related Substances. (ATC-Code: L01DA01).
Mechanism of action
Binds to the guanine portion of DNA intercalating between guanine and cytosine base pairs inhibiting DNA and RNA synthesis and protein synthesis.
Therapeutic use
Treatment of testicular tumors, melanoma, gestational trophoblastic neoplasm, Wilms’ tumor, neuroblastoma, retinoblastoma, rhabdomyosarcoma, uterine sarcomas, Ewing’s sarcoma, Kaposi’s sarcoma, sarcoma botryoides, and soft tissue sarcoma.
Pregnancy and lactiation implications
Animal studies demonstrated teratogenic effects and fetal loss. Women of childbearing potential are advised not to become pregnant. Use only when potential benefit justifies potential risk to the fetus. Avoid exposure during pregnancy. Not recommended during lactation.
Unlabeled use
Contraindications
Hypersensitivity to dactinomycin or any component of the formulation. Patients with concurrent or recent chickenpox or herpes zoster. Avoid use in infants <6 months of age.
Warnings and precautions
Avoid inhalation of vapors or contact with skin, mucous membrane, or eyes. Avoid exposure during pregnancy. If extravasation occurs during I.V. use, severe damage to soft tissues will occur. May cause veno-occlusive liver disease, (increased risk in children <4 years of age; caution in hepatobiliary dysfunction). Potentiates effects of radiation therapy. May result in increased GI toxicity or myelosuppression. Avoid administration of live vaccines.