Dactinomycin - Intravenous

Dactinomycin is used on its own or together with other medicines to treat certain types of cancer of the bone, muscle, kidneys, womb, and testicles.

This medicine may also be used to treat other conditions as decided by your doctor.

Dactinomycin is to be given intravenously (into the vein) as an infusion. It is delivered directly into the bloodstream via the blood vessel.

Your doctor or nurse will administer the injection for you.

Before starting your treatment, you may be given other medicines to prevent or lessen the side effects of this medicine.

The dose of Dactinomycin will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type of your condition and your response to the medication.

Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Dactinomycin.

If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.

Alert your doctor if you have a contagious infection caused by varicella-zoster virus or herpes zoster known as chickenpox and shingles as Dactinomycin may not be suitable for you.

Inform your doctor if you have the following conditions:

• problems in bile duct (a tube-like channel which carries bile from the liver to the upper portion of the small intestine)
• kidney disease
• liver disease
• previously had chemotherapy or radiation therapy
• oedema (swelling of certain body parts due to fluid build-up)

Let your doctor know if you are pregnant.

Both men and women must use proven birth control methods during Dactinomycin therapy and for at least 6 months (in women) or at least 3 months (in men) after stopping the treatment. You may wish to discuss other reliable methods of birth control with your doctor.

Do not breastfeed while you are being treated with this medicine and for 14 days after the last dose.

Be sure to check with your doctor or pharmacist before giving Dactinomycin to a child or the elderly. Children and elderly people may be more sensitive to the side effects.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Pregnancy tests must be done before treatment to know if this medicine is suited for you to use.
• Routine tests (e.g. complete blood count, liver and kidney function) may be done before and while you are being treated with Dactinomycin. Your doctor will advise you about how often you will need to have these tests.
• Regular monitoring for signs of liver problems, skin reactions and infusion site reactions may also be needed.

Dactinomycin may cause any of the following side effects: nausea, vomiting, diarrhoea, constipation, mouth sores, cracked lips, loss of appetite, muscle pain, weakness, fever, hair loss, and pimples.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
• new skin lesions, rashes with blistering or peeling of the skin, mouth or ulcers
• burning or stinging sensation and severe pain at the infusion site

This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Avoid vaccinations with live vaccines during treatment with Dactinomycin. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children. Do not freeze this medicine otherwise, it will no longer be effective and should not be used.

Protect from light and humidity.

Medicines must not be used past the expiry date.

As Dactinomycin is a cancer medicine, always return any unused or expired medicine to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.