Drug reference

Dactinomycin

Antineoplastic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

and reproductive function in Cytotoxic drugs

FDA category + note

Top interactionssee all 12 →

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Mechanism

Dactinomycin exerts its antineoplastic effects primarily by intercalating into the minor groove of DNA, specifically between adjacent guanine-cytosine base pairs. This molecular interaction directly inhibits DNA-dependent RNA synthesis (transcription) and DNA replication, disrupting critical cellular processes. Furthermore, dactinomycin causes DNA strand breaks, leading to profound DNA damage, cell cycle arrest, and ultimately inducing apoptosis and cell death in rapidly dividing cancer cells.

Indications

Paediatric cancersRhabdomyosarcoma (in children, with primary surgery, radiotherapy, vincristine, and cyclophosphamide)Wilms tumor (in children, with primary surgery, radiotherapy, vincristine, and cyclophosphamide)Ewing sarcomaKaposi sarcomaSoft-tissue sarcomasChoriocarcinoma (with methotrexate)Wilms’ tumourChildhood rhabdomyosarcomaMtx resistant choriocarcinomaEwing’s sarcomaMetastatic testicular carcinoma

Dosing

Adult: patients with creatinine clearance less than 10 mL/minute.

Pharmacokinetics

Half-life

36 h (terminal t1/2)

Protein binding

Does not cross the blood-brain barrier.

Metabolism

Minimal metabolism.

Excretion

Excreted in both bile and urine.

Side effects

Common

AnorexiaNauseaVomitingHematopoietic suppression (pancytopenia, first week after therapy)ProctitisDiarrheaGlossitisCheilitisUlcerations of the oral mucosaAlopeciaErythemaDesquamationIncreased inflammation and pigmentation in areas previously or concomitantly subjected to X-ray radiationStomatitisDiarrhoeaDesquamation of skin

Serious