L01DA01 - Dactinomycin |
Not porphyrinogenic |
NP |
Rationale
Undergoes only minimal metabolism, insignificant hepatic exposure. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Highly toxic antibiotic isolated from Streptomyces parvulus.
Therapeutic characteristics
Dactinomycin is used in the tratment of Wilms tumor, gesatational trophoblastic tumors, nonseminomatous testicular cancer, sarcomas such as rhabdomyosarcoma and Ewings sarcoma. Administered as an intravenous infusion. Common adverse reactions of dactinmycin that can be confused with an acute porphyric attack are vomiting, abdominal pain and nausea. Side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Hepatic exposure
Insignificant.
Metabolism and pharmakokinetics
Dactinmycin undergoes minimal metabolism. Slowly excreted mainly in unchaged form in urine and bile.
Published experience
Uneventful use reported in male AIP patient with testicular cancer (Arbus et al, 1981).
IPNet drug reports
No.
References
- Scientific articles
- Arbus MH. Relationship between porphyria and the use of antineoplastics. Am J Hosp Pharm. 1981;38(5):631. PMID 7282689. #1993
- Drug reference publications
- McEvoy GK, editor. Dactinomycin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (04.05.10). #1994
- Sweetman SC, editor. Martindale: The complete drug reference. Dactinomycin. Pharmaceutical Press 2009. #1996
- Summary of Product Characteristics
- Norwegian medicines agency. Summary of Product Characteristics (SPC). Cosmegen. #1995
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