Dactinomycin

Indications & Dose:

Wilm’s tumour, rhabdomyosar- coma, metastatic and non-metastatic choriocarcinoma, nonseminomatus testicular carcinoma, Ewing’s sarcoma, sarcoma botryoides.

DOSE

Adults i.v. 0.5mg per day for maximum of 5 days.

Children i.v. 0.015mg/kg/day for 5 days. Alternative schedule is a total doses of 2.5mg/m2 i.v. over 1 week. In both adult and children administer 2nd course after at least 3 weeks, provided all signs of toxicity have disappeared. 

Contraindications:

It should not be given at the time of infection with chicken pox or herpes zoster, severe generalised disease may occur.

Side Effects:

Oral: Cheilitis dysphasia, oesophagitis, ulcerative stomatitis, pheryn-gitis.

GI: Abdominal pain, GI ulceration, liver toxicity.

Haematologic: anaemia, agranulocytosis, leucopoenia.

Dermato-logic: Alopecia, skin eruption, acne, pigmentation.

Cautions:

Precautions:

May cause anaphylactoid reactions, nausea, vomiting. With combination of drug while giving radiation, skin buccal and pharyngeal mucosa show early erythema and vasiculation, increased incidence of GI toxicity and marrow suppression. Do not give to infants less than 12 months of age because of greater toxic effects.
Pregnancy & breast-feeding: Use only when clearly indicated.
Old age: May be used.

Interaction:

Drugs May interfere with bioassay procedure for determination of antibacterial drug levels.

Mitomycin C: Acute pulmonary reaction may occur.
Phenytoin: Reduced phenytoin plasma levels

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: