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Daunorubicin information from DrugsUpdate  

See Available Brands of Daunorubicin in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation

Daunorubicin or daunomycin (daunomycin cerubidine) is chemotherapy of the anthracycline family that is given as a treatment for some types of cancer. It is most commonly used to treat specific types of leukaemia (acute myeloid leukemia and acute lymphocytic leukemia). It was initially isolated from Streptomyces peucetius. A liposomal formulation of daunorubicin is marketed in the United States as DaunoXome.

Pharmacodynamics

Pharmacokinetics

Daunorubicin forms a stable complex with DNA and interferes with the nucleic acid synthesis. It is a cell-cycle nonspecific agent, but its cytotoxic effects are mostly marked in the S-phase. It also has immunosuppressant and antibacterial effects.


Distribution Body tissues; crosses the placenta; enters breast milk.


Metabolism Hepatic; converted to daunorubicinol.


Excretion Urine (as active form). Elimination half-life: 18.5 hr (daunorubicin), 26.7 hr (active metabolite).

Daunorubicin Indications / Daunorubicin Uses

Information Not Available

Daunorubicin Adverse Reactions / Daunorubicin Side Effects

GI disturbances; stomatitis; alopoecia and dermatological reactions. Extravasation of daunorubicin may cause severe local tissue necrosis damaging surrounding muscles, tendons and nerves. IV infusion, back pain, flushing and chest tightness. Potentially Fatal: Bone marrow suppression, cardiac toxicity, cardiomyopathy and congestive heart failure.

Precautions

General Therapy with Daunorubicin hydrochloride requires close patient observation and frequent complete blood-count determinations. Cardiac, renal, and hepatic function should be evaluated prior to each course of treatment. Appropriate measures must be taken to control any systemic infection before beginning therapy with Daunorubicin hydrochloride. Daunorubicin hydrochloride may transiently impart a red coloration to the urine after administration, and patients should be advised to expect this. Overdosage Severe myelosupression, cardiotoxicity with or without transient reversible ECG changes leading to CHF. Treatment is supportive and symptomatic.

Special Precautions

Regular blood count and ECG monitoring; elderly, children. Hepatic or renal impairment may increase risk of toxicity. Pre-existing cardiac disease and previous treatment with doxorubicin. Myocardial toxicity leading to potentially fatal congestive heart failure may occur during therapy or mth to yr after therapy cessation. Incidence of myocardial toxicity increases after total cumulative dose exceeds 400-550 mg/m2 in adults, 300 mg/m2 in children >2 yr, or 10 mg/kg in children <2 yr. Risk of severe myelosuppression leading to infection or haemorrhage.

Other Drug Interactions

Increased risk of cardiotoxicity when used with cyclophosphamide. Increased risk of hepatic toxicity when used with hepatotoxic drugs e.g. high-dose methotrexate. Potentially Fatal: Immunisation with live vaccines is not recommended. Concurrent radiation may lead to increased radiation reaction.

Other Interactions

Information Not Available

Dosage

Intravenous Acute leukaemias Adult: 30-45 mg/m2 BSA daily on days 1-3 of the induction course and days 1 and 2 for the subsequent courses. Admin as a solution in 0.9% sodium chloride into a fast-running infusion of sodium chloride or glucose. May repeat course 3-6 wk later. Max (total cumulative dose): 550 mg/m2 in patients without risk factors for cardiotoxicity and 400 mg/m2 in patients who have received chest radiotherapy. Child: For acute lymphoblastic leukaemia: 25 mg/m2 BSA once wkly in combination with other regimens. <2 yr old or BSA <0.5 m2: 1 mg/kg once wkly. Max (total cumulative dose): 300 mg/m2 and in children <2 yr: 10 mg/kg. Renal impairment: Based on serum-creatinine concentrations: 105-265 micromoles/l: 75% of the usual dose; >265 micromoles/l: 50% of the usual dose. Hepatic impairment: Based on serum bilirubin concentrations of 12-30 mcg/ml: 75% of the usual dose; >30 mcg/ml: 50% of the usual dose. Intravenous AIDS-related Kaposi's sarcoma Adult: As the liposomal formulation: Initially, 40 mg/m2 once every 2 wk, diluted in glucose 5% to a concentration of 0.2-1 mg/ml and given over 30-60 minutes. May continue for as long as disease control can be maintained. Renal impairment: Based on serum-creatinine concentrations: 105-265 micromoles/l: 75% of the usual dose; >265 micromoles/l: 50% of the usual dose. Hepatic impairment: Based on serum bilirubin concentrations of 12-30 mcg/ml: 75% of the usual dose; >30 mcg/ml: 50% of the usual dose. Incompatibility Incompatible with heparin sodium and dexamethasone sodium phosphate solution.

Food(before/after)

Information Not Available

List of Contraindications

Daunorubicin and Pregnancy

Contraindicated in pregnancy Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Daunorubicin and Lactation

Contraindicated in lactation

Daunorubicin and Children

Information Not Available

Daunorubicin and Geriatic

Information Not Available

Daunorubicin and Other Contraindications

Heart failure. Pregnancy, lactation

Storage

Intravenous Powder for inj: Store at 15-25 ℃. Solution for inj & liposomal inj: Refrigerate at 2-8 ℃. Do not freeze.

Lab interference

Intravenous Powder for inj: Store at 15-25 ℃. Solution for inj & liposomal inj: Refrigerate at 2-8 ℃. Do not freeze.

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