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Drug Notebook

FDA Alerts

  • Powder and solution are highly toxic (e.g., corrosive, carcinogenic, mutagenic, teratogenic). (See Toxicity and Adequate Patient Monitoring under Cautions.)
  • Handle and administer with care; avoid inhalation of dust or vapors and contact with skin or mucous membranes, especially the eyes. (See IV Administration under Dosage and Administration.)
  • Avoid exposure during pregnancy. (See Fetal/Neonatal Morbidity and Mortality under Cautions.)
  • Highly corrosive to soft tissue; severe damage to soft tissues if extravasation occurs. Contracture of the arms has been reported. (See Local Effects under Cautions.)
  • Administer only under the supervision of a qualified clinician experienced in the use of cancer chemotherapeutic agents.

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dactinomycin
(dak ti noe MYE sin)

What is this medicine?
DACTINOMYCIN (dak ti noe MYE sin) is a chemotherapy drug. It is used to treat many kinds of cancer like Wilms' tumor, some sarcomas, and placental and testicular cancers. It is also used to treat other solid tumors.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

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What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
  • signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
  • signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine
  • signs of decreased red blood cells - unusually weak or tired, fainting spells, lightheadedness
  • breathing problems
  • changes in vision
  • chest pain
  • mouth sores
  • pain, swelling, redness at site where injected
  • seizures
  • stomach pain, ulcers
  • swelling of the ankles, feet, hands, or stomach
  • trouble passing urine or change in the amount of urine
  • vomiting
  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • acne-like skin rash
  • darker skin color
  • diarrhea
  • hair loss
  • loss of appetite
  • nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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How should I use this medicine?
This drug is given as an infusion into a vein. It is administered in a hospital or clinic by a specially trained health care professional.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 6 months of age for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

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What if I miss a dose?
It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment.

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What may interact with this medicine?

  • medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim
  • vaccines

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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Who should NOT use this medication?

  • Current or recent infection with chickenpox or herpes zoster. (See Immunosuppression under Cautions.)
  • Known hypersensitivity to dactinomycin or any ingredient in the formulation.

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What should I watch for while using this medicine?
Your condition will be monitored carefully while you are receiving this medicine. You will need important blood work done while you are taking this medicine.

This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.

Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.

Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

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What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:

  • infection (especially a virus infection such as chickenpox, cold sores, or herpes)
  • liver disease
  • low blood counts like low platelets, red blood cells, white blood cells
  • recent radiation therapy
  • an unusual or allergic reaction to dactinomycin, other chemotherapy agents, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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