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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

DACTINomycin

( dak-tin-oh-MYE-sin )
Other Name(s): Cosmegen®
Appearance: Clear, golden solution

Medication Information Sheet
DACTINomycin (dak-tin-oh-MYE-sin)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Cosmegen®

Appearance:
Clear, golden solution

What is this medication for?

For treating certain cancers such as Wilms tumour or sarcomas, usually in combination with other medications.

What should I do before I have this medication?
  • Tell  your doctor if you have/had significant medical condition(s), especially if you have / had chickenpox or herpes zoster, have had radiation, or have any allergies.
  • People who have cancer are at a higher risk of developing other cancers. Also, some cancer medications, such as dactinomycin, may increase this risk. You should discuss this with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Dactinomycin may harm the unborn baby. Do not use this drug if you are pregnant.
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:►Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while taking this drug.
  • Effects on Fertility: Probable
How is this medication given?
  • This drug is given by injection into a vein.

 

 

 

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
What are the side effects of this medication?

Common side effects usually occur in more than 1 out of every 10 patients. Other side effects are less common, but may be severe. You may not have all of the side effects below. You may have side effects that are not listed.

The following side effects have been seen in people using DACTINomycin with other chemotherapy drugs, so some of these effects may be caused by chemotherapy.

Side effects and what to do When to contact doctor?
More Common Side Effects

Diarrhea

  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Also see Diarrhea pamphlet.*

 

Contact your health care team if no improvement or if severe

Inflammation of the surface of the mucous membrane that lines the digestive system (mouth sores, diarrhea, blood in stools, abdominal pain, difficulty swallowing)

  • Maintain good mouth hygiene. Regular teethbrushing with a soft toothbrush or Toothette®, and
  • Regular use of mouthwashes, especially after meals and at bedtime. Use alcohol-free mouthwashes.
  • Instead, try a homemade mouthwash: 
    Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
  • Avoid hot, spicy, acidic, hard or crunchy foods. 
  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice.
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Also see Mouth Care and Diarrhea pamphlet.*
Contact your health care team as soon as possible

Tiredness

  • Rest often; take naps if needed. Move slowly when getting up.
  • Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
  • Do not drive a motor vehicle or operate machinery when feeling tired.
Contact your health care team if no improvement or if severe
Reactions at the injection site (redness, itchiness, bruising, mild rash or swelling) Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

 

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
    (continue on the next page)
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Nausea and vomiting

  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
  • Also see Nausea & Vomiting pamphlet.*
Contact your health care team if no improvement or if severe

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Liver problems (weight gain, tender right side of belly, yellow skin or eyes, dark urine)

Get emergency medical help right away

Allergic reaction (fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness)

  • May occur during or shortly after the drug is given.
Get emergency medical help right away

Lung problems
(increased cough, breathing problems, chest pain, coughing blood)

 

Get emergency medical help right away

Serious skin rash (may include blisters or skin peeling)

Get emergency medical help right away

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.