Generic Name:
Actinomycin D (also known as Dactinomycin)
Dosage Form:
Powder for Injection
Strength:
0.5 mg per vial
Description:
Actinomycin D is an antineoplastic antibiotic derived from Streptomyces species. It is used primarily in the treatment of various cancers. It intercalates DNA, thereby inhibiting RNA synthesis.
Prescription:
Rx Only – Must be prescribed by a healthcare professional experienced in chemotherapy.
Pharmacological Class:
- Antineoplastic
- Cytotoxic antibiotic
Mechanism of Action:
Actinomycin D binds to the DNA double helix at the transcription initiation complex and inhibits RNA polymerase, effectively blocking mRNA synthesis and thereby halting protein synthesis, leading to cell death.
Indications:
Used as part of chemotherapy regimens for:
- Wilms’ tumor
- Ewing’s sarcoma
- Rhabdomyosarcoma
- Gestational trophoblastic neoplasia
- Testicular cancer
- Ovarian cancer
- Kaposi’s sarcoma (AIDS-related)
Advantages:
- Effective against several pediatric and adult cancers.
- Used in combination with other cytotoxic agents to improve efficacy.
Dosage and Administration:
- Administered intravenously (IV) only.
- Must be reconstituted with sterile water for injection.
- Dose is weight- and protocol-dependent, commonly between 10–15 mcg/kg/day.
⚠️ Extravasation risk: It is a vesicant — avoid paravenous administration as it can cause severe tissue necrosis.
Storage:
- Before reconstitution: Store at 2–8°C (refrigerated), protected from light.
- After reconstitution: Use immediately or as per manufacturer’s guidelines.
- Do not freeze.
Precautions:
- Myelosuppression monitoring: CBC monitoring required.
- Hepatic and renal impairment: Use cautiously; adjust dose if necessary.
- Pregnancy: Category D – teratogenic. Avoid use unless essential.
- Avoid live vaccines during treatment.
Patient Advice:
- Report signs of infection (fever, sore throat).
- Use effective contraception during treatment and for some time after.
- Maintain good oral hygiene.
- Avoid crowded places to minimize infection risk.
- Notify your doctor of any swelling, pain, or redness at the injection site.
Common Packaging:
- Glass vial containing 0.5 mg of lyophilized powder.
- Packaged with labeling indicating cytotoxic nature.