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Dactinomycin

Actinomycin D, ACT
Cosmegen

Pregnancy Category C

Drug classes

Antibiotics
Antineoplastics

Mechanism of action

Cytotoxic: inhibits synthesis of messenger RNA, causing cell death; cell cycle nonspecific.

Indications

1. Wilms' tumor
2. Rhabdomyosarcoma
3. Netastatic and nonmetastatic choriocarcinoma
4. Ewing's sarcoma
5. Sarcoma botryoides
6. Nonseminomatous testicular carcinoma
7. Potentiation of effects of radiation therapy

Contraindications

1. Allergy to dactinomycin
2. Chickenpox
3. Herpes zoster (severe, generalized disease and death could result)
4. Pregnancy
5. Lactation

Use caution in the presence of bone marrow suppression, radiation therapy.

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Adverse effects

• GI: Cheilitis, dysphagia, esophagitis, ulcerative stomatitis, pharyngitis, anorexia, abdominal pain, diarrhea, GI ulceration, proctitis, nausea, vomiting, hepatic abnormalities
• Hematologic: Anemia, aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia, pancytopenia, reticulopenia
• Dermatologic: Alopecia, skin eruptions, acne, erythema, increased pigmentation of GU renal abnormalities
• Local: Tissue necrosis at sites of extravasation
• Other: Malaise, fever, fatigue, lethargy, myalgia, hypocalcemia, death, increased incidence of second primary tumors when used with radiation

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