Dactinom (Dactinomycin Injection 0.5mg)

Dactinomycin is FDA-approved and used in combination with other therapies for:

1. Wilms Tumor :Often used as part of a multi-agent regimen in pediatric patients.

2. Rhabdomyosarcoma :Primarily in pediatric patients, combined with surgery and/or radiation.

3. Ewing Sarcoma :Frequently combined with other chemotherapeutic agents.

4. Gestational Trophoblastic Neoplasia (GTN) :Used in high-risk or refractory cases.

5. Metastatic Nonseminomatous Testicular Cancer :As part of salvage therapy regimens.

6. Other Off-Label Uses :May be used for desmoid tumors or Kaposi sarcoma in selected cases.

Dactinomycin intercalates into DNA, interfering with RNA synthesis and causing DNA strand breaks. This inhibits tumor growth by:

1. Blocking Transcription :Prevents RNA polymerase from functioning.

2. Inducing Apoptosis :DNA damage triggers programmed cell death in rapidly dividing tumor cells.

• 0.015 mg/kg/dayor400-600 mcg/m/dayfor 5 days, continue every 3-4 weeks depending on the cancer type.

Preparation:

* Reconstitute with sterile water for injection.

* Use immediately after reconstitution; store as per stability guidelines.

Administration:

* 0Intravenous (IV) Only :Administer via slow IV push or infusion to minimize toxicity.

* Avoid extravasation, as it can cause severe tissue damage.

1. Gastrointestinal :Nausea, vomiting, stomatitis, and diarrhea.
2. Hematologic :Myelosuppression (neutropenia, anemia, thrombocytopenia).
3. Fatigue and Weakness :Generalized but reversible.

1. Tissue Necrosis :Extravasation can lead to severe local tissue injury and necrosis.
2. Hepatotoxicity :Elevated liver enzymes or veno-occlusive disease, particularly in children.
3. Severe Myelosuppression :Can result in life-threatening infections or bleeding.
4. Secondary Malignancies :Rare but possible long-term risk.
5. Hypersensitivity Reactions :Rash, urticaria, or anaphylaxis in rare cases.

1. Pregnancy and Breastfeeding
2. Handling Precautions
3. Extravasation:Immediate interventions include stopping infusion and applying antidotes likedimethyl sulfoxide (DMSO).

1. Wilms Tumor :Improves survival rates when combined with surgery, radiation, and other chemotherapies.
2. Rhabdomyosarcoma :Effective as part of multi-agent therapy in achieving remission.
3. Gestational Trophoblastic Neoplasia (GTN)

1. Hepatotoxic Drugs :Concurrent use (e.g., methotrexate) may exacerbate liver damage.
2. Radiation Therapy :Increased risk of radiation recall reactions (severe skin or tissue inflammation at irradiated sites).