Composition
Inj:Actinomycin D 0.5 mg per 3 ml vial.
Indications & Dosage
Choriocarcinoma, Ovarian teratoma, Wilms tumour, Rhabdomyosarcoma, Testicular teratoma, Ewings sarcoma, Neuroblastoma (adjunct): Adults: 2.5 mg/m2 in divided doses, over 1 week, repeated every 2 weeks or 0.75-2 mg/m2 every 1-4 weeks or 400-600 mg/m2/day for 5 days, repeated every 3-6 weeks. Refer to individual protocol.
Administration
Infuse over 10-15 min. Avoid extravasation. Extremely damaging to soft tissue and will cause a severe local reaction if extravasation occurs. Administer slow IV push over 10-15 min. An in line cellulose membrane filter should not be used during administration of Dactinomycin soln. Do not give IM or SC. Dilute with 1.1 ml of preservative-free SWFI to yield a final concentration of 500 mcg/ml; do not use preservative diluent as precipitation may occur.
Compatibility
Stable in D5W, NS, SWFI.
Contraindications
Patients with concurrent or recent chickenpox or herpes zoster, anaphylactic reaction
Precautions
Use with caution in patients with blood disorder, gout, dental disease, heart disease, who have received radiation therapy. Avoid use within 2 months of radiation treatment for right-sided Wilms tumor, may increase the risk of hepatotoxicity. Discontinue treatment with severe myelo-suppression, diarrhoea or stomatitis. Avoid use in infants below 6 months age.
Interactions
BCG; clozapine; natalizumab; pimecrolimus; tacrolimus (topical); live vaccines (avoid), leflunomide, roflumilast, trastuzumab.
Pregnancy
Positive evidence of risk: Avoid
Lactation
Contraindicated. Discontinue breast feeding
Side Effects
Radiosensitization effects, bone marrow suppression, neutropenic fever, anaphylactic reaction, fatigue, alopecia (reversible), Stevens-Johnson syndrome, growth retardation, hyperuricemia, abdominal pain, anorexia, diarrhoea, GI ulceration, nausea, vomiting, anaemia, increased bilirubin, hepatotoxicity, liver function test abnor-mality , erythema oedema, myaliga.