Daunomycin

Cytostatic · Cytotoxic antibiotic

Indications

Acute leukaemia (lymphoblastic, myeloblastic, monoblastic, haemocytoblast, stem cell), chronic myeloid leukaemias (reticulosarcoma, lymphosarcoma), neuroblastoma, rhabdomyosarcoma.

Dosage

Adults: 0.8 mg/kg IV and continue with a maintenance dose of 0.8-1 mg/kg. Max 25 mg/kg. Children: Initial dose of 1 mg/kg of daunomycin by IV daily for 4-5 days, max 25 mg/kg. See literature.

Administration

IV: Never administer IM or SC. Administer IVP over 1-5 min into the tubing of a rapidly infusing IV solution of D5W or NS; Daunorubicin has also been diluted in 100 mL of D5W or NS and infused over 15-30 min. Extravasation management: Apply ice immediately for 30-60 min; then alternate off/on every 15 min for 1 day. Topical cooling may be achieved using ice packs or cooling pad with circulating ice water. Cooling of site for 24 hours as tolerated by the patient. Elevate and rest extremity 24-48 hours, then resume normal activity as tolerated. Application of cold inhibits vesicant's cytotoxicity. Application of heat or sodium bicarbonate can be harmful and is contraindicated. If pain, erythema and/or swelling persist beyond 48 hours, refer patient immediately to plastic surgeon for consultation and possible debridement. Reconstitution: Dilute vials with 4 mL SWFI for a final…

Risk Factor (Pregnancy/Lactation)

Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended.

Advice to Patient

Apply ice if you have pain/redness/swelling at the IV site, and inform prescriber. Wash hands regularly and avoid highly crowded places to prevent infection. To treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water. Contact prescriber if there is fever, chills, difficulty in breathing, swelling on face. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. To minimize bleeding, use soft toothbrush and electric razor. Avoid sports and activities that may cause injury. Take sufficient rest and small, frequent meals to maintain good nutritional status. Avoid direct sunlight, use protective clothing, wear sunscreen (SPF 15 or higher) and eyewear to prevent photosensitivity. Avoid using sunlamp, tanning bed or…

Pharmacokinetics

Absorption: IV: Rapidly distributed into body tissues. Metabolism: Hepatic. Half-life elimination: Initial: 45 mins. Terminal: 18.5 hrs. Excretion: Urine (25%). Faeces (40%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.