dactinomycin

Generic Name: dactinomycin (DAK tin oh MYE sin)

Brand Names: Cosmegen

What is dactinomycin?

Dactinomycin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Dactinomycin is used to treat different types of cancers that affect the kidneys, uterus, testicles, bones, muscles, joints, and soft tissues. Dactinomycin is also used to treat solid tumors.

Dactinomycin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about dactinomycin?

Do not use dactinomycin if you are pregnant. It could harm the unborn baby. Do not receive a "live" vaccine while using dactinomycin, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine. You should not receive dactinomycin if you are allergic to it, or if you have recently had chickenpox or herpes zoster (shingles).

To make sure you can safely use dactinomycin, tell your doctor if you have recently received radiation treatment for Wilms' tumor.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when dactinomycin is injected. Dactinomycin can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

What should I discuss with my healthcare provider before receiving dactinomycin?

You should not receive dactinomycin if you are allergic to it, or if you have recently had chickenpox or herpes zoster (shingles).

To make sure you can safely take dactinomycin, tell your doctor if you have recently received radiation treatment for Wilms' tumor.

Using dactinomycin may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

FDA pregnancy category D. Do not use dactinomycin if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether dactinomycin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using dactinomycin.

How should I use dactinomycin?

Dactinomycin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Dactinomycin is usually given only on certain days during a treatment cycle. How often you receive this medication depends on the condition being treated.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when dactinomycin is injected.

Dactinomycin can be harmful if it gets in your eyes, mouth, or nose, or on your skin. If skin contact occurs, rinse with plain water for at least 15 minutes.

Dactinomycin can lower blood cells that help your body fight infections. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your dactinomycin injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while using dactinomycin?

Avoid getting this medicine on your clothes. Destroy any clothing the medicine has leaked onto if an accidental spill occurs.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using dactinomycin, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Dactinomycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

• 
  

  pain, swelling, burning, irritation, or skin changes where the injection was given;

  
  


• 
  

  fever, chills, body aches, diarrhea, flu symptoms, sores in your mouth and throat;

  
  


• 
  

  swelling or tenderness in your upper stomach, weight gain, dark urine, jaundice (yellowing of the skin or eyes);

  
  


• 
  

  feeling short of breath, urinating less than usual or not at all;

  
  


• 
  

  chest pain, dry cough, wheezing;

  
  


• 
  

  pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  
  


• 
  

  easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  
  


• 
  

  any wound that will not heal; or

  
  


• 
  

  redness or your skin or the inside of your mouth and throat (if you are also receiving radiation treatment).

  
  

Less serious side effects may include:

• 
  

  nausea, vomiting, stomach pain, loss of appetite;

  
  


• 
  

  tired feeling, muscle pain;

  
  


• 
  

  rectal pain or bleeding;

  
  


• 
  

  numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes;

  
  


• 
  

  hair loss;

  
  


• 
  

  dry or cracked skin, chapped lips; or

  
  


• 
  

  acne, mild skin rash.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Dactinomycin Dosing Information

Usual Adult Dose for Wilms' Tumor:

15 mcg/kg/day or 400 to 600 mcg/m2/day intravenously for 5 days as a part of a combination regimen. Dosage for obese or edematous adult patients may be calculated on the basis of body surface area to relate dosage to lean body mass. Dosage may be repeated every 3 to 6 weeks.

Usual Adult Dose for Ewing's Sarcoma:

15 mcg/kg/day or 400 to 600 mcg/m2/day intravenously for 5 days as a part of a combination regimen. Dosage for obese or edematous adult patients may be calculated on the basis of body surface area to relate dosage to lean body mass. Dosage may be repeated every 3 to 6 weeks.

Usual Adult Dose for Rhabdomyosarcoma:

15 mcg/kg/day or 400 to 600 mcg/m2/day intravenously for 5 days as a part of a combination regimen. Dosage for obese or edematous adult patients may be calculated on the basis of body surface area to relate dosage to lean body mass. Dosage may be repeated every 3 to 6 weeks.

Usual Adult Dose for Testicular Cancer:

For use in the treatment of metastatic nonseminomatous testicular cancer:

1000 mcg/m2 intravenously on day 1 as part of a combination regimen with cyclophosphamide, bleomycin, vinblastine, and cisplatin.

Usual Adult Dose for Trophoblastic Disease:

For use in the treatment of gestational trophoblastic neoplasia:

12 mcg/kg intravenously daily for five days as a single agent.

or

500 mcg intravenously on days 1 and 2 as part of a combination regimen with etoposide, methotrexate, folinic acid, vincristine, cyclophosphamide and cisplatin.

Usual Adult Dose for Malignant Disease:

For use as a component of regional perfusion in the palliative and/or adjunctive treatment of locally recurrent or locoregional solid malignancies:

50 mcg/kg for lower extremity or pelvis

or

35 mcg/kg for upper extremity.

(Please note that the dosage schedules and the technique itself vary from one investigator to another. Please consult the published literature for details.)

Usual Adult Dose for Osteosarcoma:

600 mcg/m2/day on days 1, 2, and 3 as part of a combination chemotherapy regimen

Usual Adult Dose for Ovarian Cancer:

For use in the treatment of ovarian (germ cell) tumor:

500 mcg/day for 5 days every 4 weeks

or

300 mcg/m2/day for 5 days every 4 weeks

Usual Pediatric Dose for Wilms' Tumor:

Greater than 6 months:

15 mcg/kg/day or 400-600 mcg/m2/day intravenously for 5 days (in various combination regimens and schedules). Dosage may be repeated every 3 to 6 weeks.

Usual Pediatric Dose for Ewing's Sarcoma:

Greater than 6 months:

15 mcg/kg/day or 400-600 mcg/m2/day intravenously for 5 days (in various combination regimens and schedules). Dosage may be repeated every 3 to 6 weeks.

Usual Pediatric Dose for Rhabdomyosarcoma:

Greater than 6 months:

15 mcg/kg/day or 400-600 mcg/m2/day intravenously for 5 days (in various combination regimens and schedules). Dosage may be repeated every 3 to 6 weeks.

Usual Pediatric Dose for Testicular Cancer:

For use in the treatment of metastatic nonseminomatous testicular cancer:

1000 mcg/m2 intravenously on day 1 as part of a combination regimen with cyclophosphamide, bleomycin, vinblastine, and cisplatin.

Usual Pediatric Dose for Trophoblastic Disease:

For use in the treatment of gestational trophoblastic neoplasia:

12 mcg/kg intravenously daily for five days as a single agent.

or

500 mcg intravenously on days 1 and 2 as part of a combination regimen with etoposide, methotrexate, folinic acid, vincristine, cyclophosphamide and cisplatin.

Usual Pediatric Dose for Malignant Disease:

For use as a component of regional perfusion in the palliative and/or adjunctive treatment of locally recurrent or locoregional solid malignancies:

50 mcg/kg for lower extremity or pelvis

or

35 mcg/kg for upper extremity.

(Please note that the dosage schedules and the technique itself vary from one investigator to another. Please consult the published literature for details.)

Usual Pediatric Dose for Osteosarcoma:

600 mcg/m2/day on days 1, 2, and 3 as part of a combination chemotherapy regimen

What other drugs will affect dactinomycin?

There may be other drugs that can interact with dactinomycin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More dactinomycin resources

• Dactinomycin Side Effects (in more detail)
• Dactinomycin Dosage
• Dactinomycin Use in Pregnancy & Breastfeeding
• Dactinomycin Drug Interactions
• Dactinomycin Support Group
• 0 Reviews for Dactinomycin - Add your own review/rating

• dactinomycin Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information


• Cosmegen Prescribing Information (FDA)


• Dactinomycin Professional Patient Advice (Wolters Kluwer)


• Dactinomycin Monograph (AHFS DI)


• Dactinomycin MedFacts Consumer Leaflet (Wolters Kluwer)

Compare dactinomycin with other medications

• Cancer
• Ewing's Sarcoma
• Osteoarthritis
• Osteosarcoma
• Ovarian Cancer
• Rhabdomyosarcoma
• Testicular Cancer
• Trophoblastic Disease
• Wilms' Tumor

Where can I get more information?

• Your doctor or pharmacist can provide more information about dactinomycin.

See also: dactinomycin side effects (in more detail)