Description of the medicine: Dactinomycin (Dactinomycinum)
Antibiotic of the group of actinomycins, from the products of vital activity Str. Parvullis and other actinomycetes.
The structure is acrinocinyl-di- (L-threonyl-D-valinyl-L-prolinylsarcosyl-N-methyl-L-valinyl) -lactone.
Synonyms: Actinomycin D, Actinomycin D, Cosmegen, Cosmogen, Meractinomycin.
The powder is orange-red. It is difficultly soluble in water at a temperature from +8 C to +10 C, practically insoluble in water at a temperature of + 37 C.
The drug has antitumor activity. The mechanism of action is based on the formation of a complex of antibiotic with DNA and the violation of its matrix activity.
Apply alone or (more often) in combination with other medicines and radiation therapy, with trophoblastic disease (chorio carcinoma of the uterus), Wilms tumor, reticulosarcoma, rhabdomyosarcoma (in children), Ewing tumor, testicular malignant tumors, lymphogranulomatosis and other tumors. The drug is also used in combined chemotherapy of disseminated melanoma.
Introduce intravenously in the form of a ready-made solution for injection (Solutio Dactinomycini pro injectionibus) - a transparent liquid of orange color; PH 4, 0 - 6, 5. In 1 ml contains 0.5 mg (500 μg) of dactinomycin.
Apply 5 - 7-day courses with repetition of courses in 3 - 8 weeks. A single dose for adults is 10 μg / kg, for children - 15 μg / kg (calculated on the surface of the body is 450 μg / m 2 for adults and children). They also use a 20-day regimen with a single dose of 5 μg / kg every other day. With poor tolerability, reduce the dose or increase the intervals between administrations.
Dactinomycin can be used in combination chemotherapy with other drugs (adriamycin, cyclophosphamide, etc.) and radiotherapy.
When using the drug, nausea, vomiting, fever, stomatitis, skin rashes, alopenia are possible. Relatively often there are 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. At a white blood cell level below 4 × 10 9 / L and platelets below 150 × 10 9 / L, the drug is stopped. It is also necessary to monitor the function of the liver and kidneys.
Do not get the solution under the skin because of the possible development of necrosis.
The drug is contraindicated in case of severe 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, with pregnancy, violations of the liver and kidneys.
Form release: injection for injection (Solutio Dactinomycini pro injectionibus) to 1 ml (in rheopolyglucose) with 0.5 mg of the drug.
Storage: List A. In the dark place at a temperature of not more than +10 C.