Among the drugs used in anticancer therapy, there are often special antitumor antibiotics. One such remedy is Dactinomycin.
Composition, Form and Packing
The active ingredient Dactinomycin is a mixture of actinomycins produced by the microorganisms Streptomyces parvullus, called dactinomycin. The auxiliary substance of the drug is mannitol.
Producer
JSC Omutninsk Scientific Experimental and Industrial Base, Russia.
Indications for use
Antitumor antibiotic is indicated with:
- Ewing's sarcoma;
- Wilms Tumors;
- Trophoblastic tumors;
- Rhabdomyosarcoma;
- Neseminomnyh cancers of the testicles;
- Solid formations of locally advanced or locally recurring nature.
Contraindications
Dactinomycin is contraindicated if there is:
- Age is less than six months;
- Chickenpox;
- Hepatic insufficiency;
- Lichen girdle;
- Lactation / Pregnancy;
- Pronounced oppression of bone marrow functions;
- Hypersensitivity to the antibiotic itself or to any of its components.
With special care, you need to use Dactinomycin in the antitumor therapy of elderly patients or individuals after radiation and chemotherapeutic treatment.
Pharmacological action
Dactinomycin belongs to the antitumor antibiotic drugs of the actinomycin group. The components of the drug bind to DNA, reducing the rate of formation of RNA, proteins and DNA.
After applying the drug, its high concentrations are observed in bone marrow and tumor structures, liver and kidney tissues, glands of the upper jaw. In minimal quantities it is excreted by the liver.
The components of the drug are not practically metabolized, accumulating in nuclear cellular structures. Within 3-5 minutes after the injection, the maximum concentration is reached in the blood. The half-life takes about 36 hours.
Instructions for use Dactinomycin: dosage
The dosage for each cancer patient is determined individually. If the patient has previously had radiation or chemotherapeutic effects, then a reduction in the traditional dosage may be necessary.
In general, with a course of therapy at 2 weeks, the dosage should not be higher than 15 μg / kg( with the condition that intravenous infusion will be administered for 5 days.)
If the patient is obese or simply overweight or swelling,, so that it corresponds to the doses of patients with normal weight. In addition, the dosage may differ according to the existing tumor process
- In a Wilms tumor, 45 μg / kg of the drug is administered intravenously in various therapeuticallyin combination with other chemotherapeutic drugs
- With Ewing's sarcoma, the dosage is 1.25 mg / m2 body
- For rhabdomyosarcomas, intravenous administration at a dosage of 15 μg / kg is given for 5 days
- For trophoblastic tumor lesions, a monotherapy injection of 12 μg /g daily for 5 days
- In non-seminiferous egg formations, 1000 μg / m2 is administered on the first day, combining Dactinomycin with Cisplatinum, Vinblastine, Bleomycin and Cyclophosphamide.
- With solid formations of locally advanced or local regenerative type, 50 μg / kg of preparation is prescribed.
If dactinomycin is assigned to an elderly cancer patient, factors such as decreased functionality of the renal and hepatic system, the heart and the presence of all kinds of associated pathologies are necessarily taken into account.
Dactinomycin is a highly toxic preparation, so it must be treated with extreme caution. Avoid contact with mucous membranes or skin, inhaling vapors or microparticles of powder.
If the product gets into the eyes, rinse immediately with water and consult an ophthalmologist. If the solution has got on the skin, then the affected area should be washed with running water for at least a quarter of an hour.
Side effects of
The drug has many side effects, among them:
- Erythematous multifunctional lesions;
- General malaise and a feeling of constant fatigue, lethargy and feverish conditions;
- Skin rashes and itching, hyperpigmentation, acne and alopecia;
- Nausea-vomiting syndrome and anorexia, epigastric tenderness and stomach ulcers, diarrhea, hepatitis and ascites, toxic processes in the liver, liver failure with a high risk of death;
- If the solution gets on the skin, then tissue necrosis, inflammation of the affected area, soreness and redness is observed;
- In the hematopoiesis system there are side reactions like neutropenia and anemia, leukopenia and agranulocytosis, thrombocytopenia, etc.;
- Endoflebitis and thrombosis of the veins of the liver;
- Myalgia and stomatitis, pneumonitis and infection, hypocalcaemia or proctitis, pharyngitis, etc.
Toxic reactions, except for nausea and vomiting symptoms, usually occur 2-4 days after the end of admission. There are confirmed data on deaths due to the development of pronounced adverse reactions.
Overdose
There are only limited data on overdose cases.
In a similar situation, oncological patients have nausea-vomiting and ulcerative lesions of the stomach, stomatitis and diarrhea, acute forms of kidney failure, skin lesions and venous thrombosis, sepsis with a high probability of death.
Dactinomycin does not have an antidote; therefore, treatment with an overdose has a supportive, symptomatic character.
Specific instructions
The drug must be taken strictly under medical supervision, having enough experience in the use of chemotherapeutic antitumor drugs.
During treatment it is necessary to control the level of leukocytes and platelets, liver and kidney functions.
- If, during treatment, severe myelosuppression develops, the treatment is discontinued for 3 weeks until bone marrow functions are restored.
- When injecting the drug, it is necessary to avoid fluid leakage into the surrounding tissues( extravasation).If, during the introduction, the patient feels pain and burning, then immediately stop the further administration of the drug.
- If high doses of the drug are given simultaneously, a pronounced reaction may develop, especially if there is a sensitivity to dactinomycin.
- There are alarming data about frequent cases of secondary cancer development after therapy according to schemes including Dactinomycin.
- After a course of such therapy, it is necessary to protect against possible pregnancy for at least 3 months for patients of both sexes.
- In the course of treatment with Dactinomycin it is worth to refrain from activities related to driving, complicated mechanisms, etc.
Drug Interaction
For the duration of the drug, antiviral vaccination should be avoided in order to avoid complications associated with excessive activity of the introduced virus.
Dactinomycin weakens the effect of vitamin K and enhances the cardiotoxic effect of doxorubicin.
Reviews
Faith:
My dad was prescribed this drug for a tumor in the testicle in combination with other means. There were many adverse reactions, and given that they took several drugs, it is difficult to say which of them caused such an organism response. But in general, the treatment resulted in a sustainable positive result.
Anna:
My sister has a swelling in her chest. She was stripped of her education, but six months later she appeared again. They did chemistry, then they prescribed and Dactinomycin. The drug is not bad, but there were obvious pobochki. Although, given the specificity of the disease, do not care about any pobochki, if only to win the disease, which we have succeeded.
Prices Дактиномицина
The average cost of the drug is about 14500-18000 rubles.
Analogues of
A similar therapeutic effect has the following preparations:
- Idarubicin;
- Reumitsin;
- Bleomycetin hydrochloride;
- Bruneiomycin;
- carminomycin, etc.
Synonyms
congeners are drugs such as Kosmegen Aknomid and D, and Luvolak Meraktinomitsin.
Terms of dispensing from pharmacies
It is released only by prescription.
Storage conditions and shelf life
The preparation should be stored under temperature conditions not exceeding 10 ° C.Duration of storage is not more than 2 years.