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DAUNOTEC

DAUNORUBICIN · by A. J. MIRZA

ANTINEOPLASTICS Cytotoxic antibiotic A. J. MIRZA

Composition

Inj: Vial containing 20 mg of daunorubicin HCI as powder, and vial containing 10 ml of saline solution.

Indications & Dosage

Acute myelogenous leukaemia, Acute lymphocytic Leukaemia, Advanced AIDS-related Kaposis sarcoma: BY IV INF: Adults: 0.8 mg/kg continue with a maintenance dose of 0.8-1 mg/kg; max 25 mg/kg. (consult product literature). Children: Initial dose of 1 mg/kg of daunomycin daily for 4-5 days, max 25 mg/kg. (consult product literature).

Administration

Never administer IM or SC. Administer IVP over 1-5 min into the tubing of a rapidly infusing IV solution of D5W or NS; Daunorubicin has also been diluted in 100 ml of D5W or NS and infused over 15-30 min. Dilute vials with 4 ml SWFI for a final concentration of 5 mg/ml.

Compatibility

Stable in D5W, LR, NS, SWFI.

Contraindications

Myocardial insufficiency, previous treatment with maximum cumulative doses of daunorubicin or other anthracycline, recent myocardial infarction, severe arrhythmia, severe renal or hepatic impairment.

Precautions

Renal and hepatic impairment, Caution is necessary with concomitant use of cardiotoxic drugs, or drugs that reduce cardiac contractility. Cardiac function should be monitored closely.

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

A lopecia,bone-marrow suppression, extravasation, hyperuricaemia, nausea, oral mucositis, thromboembolism, tumourlysis syndrome, vomiting, cardiotoxicity