Daunorubicin

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Monitor 6 Adverse-effects 7 Drug-interactions 8 Mechanism-of-action 9 More General Terms 10 Internet Database 11 References

Introduction

• Daunorubicin HCl & Daunorubicin citrate (liposomal).

• Tradenames: Cerubidine. Daunorubicin HCl, DaunoXome Daunorubicin citrate (liposomal)

Indications

• used in combination with other agents in the treatment of leukemias
• used for induction therapy in acute myeloid leukemia ( AML)
• HIV-associated Kaposi's sarcoma (liposomal) Tradename: DaunoXome. Daunorubicin citrate (liposomal).

Contraindications

• congestive heart failure
• cardiac arrhythmia
• pre-existing bone marrow suppression
  

• pregnancy category = d

Dosage

• Lyophilized powder for injection: 10, 20, 50, 200 mg.

Monitor

• evaluate cardiac, renal & hepatic function prior to each dose
• CBC prior to each dose, Hold if neutrophil count < 750/ mm3
• monitor uric acid

Adverse-effects

• common (> 10%)

• alopecia (reversible)
• reddish discoloration of the urine
• stomatitis (3-7 days after administration)
• nausea/vomiting (50%) within 1st 24 hours
• fatigue, headache, abdominal pain, anorexia, neuropathy, cough, dyspnea, rhinitis, infection

• less common (1-10%)

• gastrointestinal

• GI ulceration
• diarrhea

• cardiac toxicity: CHF maximum lifetime dose

• 550 mg/mm2 in adults
• 400 mg/mm2 in patients receiving chest irradiation
• 300 mg/mm2 in children > 2 years of age
• 10 mg/kg in children < 2 years of age

• myelosuppression

• leukopenia more significant than thrombocytopenia
• onset 7 days
• nadir 14 days
• recovery 21-28 days

• hyperuricemia
• hypertension, palpitations, syncope, tachycardia, chest pain, edema, depression, dizziness, insomnia, malaise, pruritis, hot flashes, constipation, tenesmus, arthralgia, myalgia, abnormal vision, sinusitis

• uncommon (< 1%)

• skin rash, myocarditis/ pericarditis, pigmentation of nail beds, abnormal liver function tests, chills, fertility impairment
  
• drug adverse effects of anthracyclines

Drug-interactions

• incompatible with NaHCO3, 5-fluorouracil, heparin, dexamethasone

Mechanism-of-action

• anthracyclin antibiotic
• inhibits topoisomerase II
• interferes with DNA synthesis

More General Terms

• anthracycline
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 2958
PubChem: 30323
PubChem: 2959

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998

daunorubicin, daunomycin; DNR (Cerubidine, DaunoXome)