III. Contraindications

  1. Active Varicella Zoster Virus (Chicken Pox)
  2. Active Shingles (Herpes Zoster)
  3. Age <6 months

IV. Mechanism

  1. See Antibiotic Chemotherapy
  2. Dactinomycin is a chromopeptide Antineoplastic Antibiotic extracted from the bacterium Streptomyces parvulus
  3. Dactinomycin inserts between adjacent guanine-cytosine base pairs
    1. Blocks DNA Transcription by RNA Polymerase
  4. Dactinomycin also induces single stranded DNA breaks by several postulated mechanisms
    1. Free-radical intermediate
    2. Topoisomerase 2 interaction

V. Medications

  1. Dactinomycin injection powder for solution in 0.5 mg vials

VI. Dosing

  1. See other references for disease specific dosing protocols
  2. Caution that dosing units may be written in either mg or mcg

VII. Adverse Effects

  1. Alopecia
  2. Myelosuppression
  3. Severe skin and soft tissue necrosis on extravasation
    1. Dactinomycin is a strong Vesicant (causes Blistering)

VIII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception

IX. Resources

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Related Studies

Ontology: Dactinomycin (C0010934)

Definition (CHV) a kind of cancer treatment drug
Definition (CHV) a kind of cancer treatment drug
Definition (CHV) a kind of cancer treatment drug
Definition (NCI_NCI-GLOSS) An anticancer drug that is a type of antitumor antibiotic.
Definition (NCI) A chromopeptide antineoplastic antibiotic isolated from the bacterium Streptomyces parvulus. Dactinomycin intercalates between adjacent guanine-cytosine base pairs, blocking the transcription of DNA by RNA polymerase; it also causes single-strand DNA breaks, possibly via a free-radical intermediate or an interaction with topoisomerase II. (NCI04)
Definition (MSH) A compound composed of a two CYCLIC PEPTIDES attached to a phenoxazine that is derived from STREPTOMYCES parvullus. It binds to DNA and inhibits RNA synthesis (transcription), with chain elongation more sensitive than initiation, termination, or release. As a result of impaired mRNA production, protein synthesis also declines after dactinomycin therapy. (From AMA Drug Evaluations Annual, 1993, p2015)
Definition (PDQ) A chromopeptide antineoplastic antibiotic isolated from the bacterium Streptomyces parvulus. Dactinomycin intercalates between adjacent guanine-cytosine base pairs, blocking the transcription of DNA by RNA polymerase; it also causes single-strand DNA breaks, possibly via a free-radical intermediate or an interaction with topoisomerase II. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39675&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39675&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C412" NCI Thesaurus)
Concepts Antibiotic (T195) , Amino Acid, Peptide, or Protein (T116)
MSH D003609
SnomedCT 360183007, 387353003, 64127001
English Actinomycin D, Dactinomycin, Meractinomycin, 2-bis[Cyclo(N-methyl-L-valyl-sarcosyl-L-prolyl-D-valyl-L-threonyl)]-1,9 dimethyl-4,6 3H-phenoxazinone-3, Actinomycin IV, Actinomycin I1, Actinomycin X 1, Dactinomycine, Actinomycin A IV, actinomycin-C1, Actinomycin-[thr-val-pro-sar-meval], actinomycin-D (medication), actinomycin-D, dactinomycin (medication), DACTINOMYCIN, Dactinomycin [Chemical/Ingredient], actinomycin d, actinomycin-d, DACTINomycin, dactinomycin, Dactinomycin - chemical (substance), Dactinomycin - chemical, ACTINOMYCIN D, Dactinomycin product, Dactinomycin (product), Dactinomycin (substance), actinomycin D, ACT-D, AD, actinomycin C1, DACT, Actinomycin C1
Swedish Daktinomycin
Czech daktinomycin
Finnish Daktinomysiini
French Actinomycine C1, Actinomycine D, Dactinomycine
Russian AKTINOMITSIN D, AKTINOMITSINY, DAKTINOMITSIN, AKTINOMITSIN, MERAKTINOMITSIN, АКТИНОМИЦИН D, АКТИНОМИЦИН, АКТИНОМИЦИНЫ, ДАКТИНОМИЦИН, МЕРАКТИНОМИЦИН
Japanese アクチノマイシンC1, ダクチノマイシン, メラクチノマイシン, アクチノマイシンD, アクチノマイシン
Italian Meractinomicina, Actinomicina D, Dactinomicina
Croatian AKTINOMICIN D, DAKTINOMICIN
Polish Meraktynomycyna, Daktynomycyna, Aktynomycyna
Spanish dactinomicina - compuesto químico (sustancia), dactinomicina - compuesto químico, actinomicina D, dactinomicina (producto), dactinomicina (sustancia), dactinomicina, Actinomicina D, Dactinomicina, Meractinomicina
German Actinomycin D, Dactinomycin, Meractinomycin
Portuguese Actinomicina D, Dactinomicina, Meractinomicina