Daunorubicin

Daunomycin, DNR, Rubidomycin

Mechanism :

Daunorubicin is the hydrochloride salt of an anthracycline cytotoxic antibiotic produced by a strain of Streptomyces coeruleorubidus. It has antimitotic and cytotoxic activity. It forms complexes with DNA by intercalation between base pairs. It inhibits topoisomerase II activity by stabilizing the DNA-topoisomerase II complex, preventing the religation portion of the ligation-religation reaction that topoisomerase II catalyzes. Single strand and double strand DNA breaks result.

Indication :

• Acute lymphoblastic leukemia
• Acute non-lymphocytic leukemia

Contraindications :

Contraindicated in patients with known hypersensitivity to it, in patients recently exposed to, or with existing, chickenpox or herpes zoster, in patients with existing heart disease. Reduce dose in impaired renal and hepatic function.

Dosing :

Always consult the current treatment protocol for details of dosage and scheduling.

Remission Induction:

<2 years or <0.5 m²: 1 mg/kg per protocol with frequency dependent on regimen employed.

>2 years or >0.5 m²: 25 mg/m² IV on day 1 every week (along with vincristine and prednisolone therapy) for 4 courses OR 25 to 45 mg/m² on days 1 and 8 of cycle (as a part of combination chemotherapy) OR 30 to 45 mg/m²/day for 3 days every 3 to 4 weeks.

Adverse Effect :

Myelosuppression, cardiotoxicity, reversible alopecia, rash, contact dermatitis, urticaria, nausea and vomiting, diarrhea and abdominal pain, severe local tissue necrosis if IV extravasation, anaphylactoid reaction, fever, and chills, hyperuricemia.

Interaction :

Daunorubicin: Should not be used in patients who have previously received the recommended maximum cumulative doses of doxorubicin or daunorubicin.
Cyclophosphamide: Used concurrently may result in increased cardiotoxicity.
Myelosuppressive agents: Dosage reduction of daunorubicin may be required.
Methotrexate: May impair liver function and increase the risk of toxicity.

Renal Dose :

Hepatic Dose :