Description of the medicine: Dactinomycin (Dactinomycinum)
Actinomycin group antibiotic, from Str. parvullis and other actinomycetes.
The structure is acrinocinyl-di- (L-threonyl-D-valynyl-L-prolyl sarcosyl-N-methyl-L-valinyl) -lactone.
Synonyms: Actinomycin D, Actinomycin D, Cosmegen, Cosmogen, Meractinomycin.
The powder is orange-red. It is hardly soluble in water at a temperature of + 8 ° C to + 10 ° C, practically insoluble in water at a temperature of + 37 ° C.
The drug has antitumor activity. The basis of the mechanism of action is the formation of a complex of antibiotic with DNA and a violation of its matrix activity.
It is used alone or (more often) in combination with other drugs and radiation therapy, with trophoblastic disease (uterine choriocarcinoma), Wilms tumor, reticulosarcoma, rhabdomyosarcoma (in children), Ewing's tumor, testicular malignancies, lymphogranulomatosis and other tumors. The drug is also used in combination chemotherapy for disseminated melanoma.
Enter intravenously in the form of a ready-made solution for injection (Solutio Dactinomycini pro injectionibus) - a transparent orange-colored liquid; pH 4, 0 - 6, 5. 1 ml contains 0.5 mg (500 μg) of dactinomycin.
Apply 5 - 7-day courses with repetition of courses after 3 - 8 weeks. A single dose for adults is 10 μg / kg, for children - 15 μg / kg (when calculated on the surface of the body 450 μg / m 2 for adults and children). A 20-day regimen is also used with a single dose of 5 μg / kg every other day. With poor tolerance, reduce the dose or increase the intervals between administrations.
Dactinomycin can be used in combination chemotherapy with other drugs (adriamycin, cyclophosphamide, etc.) and radiation therapy.
When using the drug, nausea, vomiting, fever, stomatitis, skin rashes, alopecia are possible. Relatively often observed leukopenia, thrombocytopenia, pancytopenia.
Treatment should be carried out under close medical supervision; the content of leukocytes in the blood is determined daily, platelets - at least 1 time in 3 days. When the level of leukocytes below 4 x 10 9 / l and platelets below 150 x 10 9 / l, the drug is stopped. Monitoring of liver and kidney function is also required.
It is not allowed to get the solution under the skin due to the possible development of necrosis.
The drug is contraindicated in the serious general condition of the patient, with the number of leukocytes less than 4 x 10 9 / l and platelets less than 150 x 10 9 / l, during pregnancy, impaired liver and kidney function.
Release form: solution for injection (Solutio Dactinomycini pro injectionibus) 1 ml (in reopoliglyukin) containing 0.5 mg of the drug.
Storage: List A. In the dark place at a temperature of no higher than + 10 C.