Daunorubicin

Daunorubicin forms a stable complex with DNA and interferes with nucleic acid synthesis. It is a cell-cycle nonspecific agent, but its cytotoxic effects are mostly marked in the S-phase. It also has immunosuppressant and antibacterial effects. It intercalates with DNA and inhibits topoisomerase II enzyme, preventing DNA replication and RNA synthesis, leading to cancer cell death.

• Acute Nonlymphocytic Leukemia (ANLL)
• Acute Lymphocytic Leukemia (ALL)

Daunorubicin forms a stable complex with DNA and interferes with nucleic acid synthesis. It is a cell-cycle nonspecific agent, but its cytotoxic effects are mostly marked in the S-phase. It also has immunosuppressant and antibacterial effects. It inhibits topoisomerase II enzyme, which is required for DNA replication and division.

Daunorubicin intercalates with DNA and inhibits topoisomerase II, preventing DNA replication and RNA synthesis, leading to cancer cell death.

Adult - ANLL (1st course): 100 mg/m²/day IV for 7 days (in combination with cytarabine).

Adult - ANLL (subsequent courses): 100 mg/m²/day IV for 5 days.

Adult - ALL (≥60 years): 45 mg/m² IV on days 1, 2, 3.

Child (≥2 years or >0.5 m² BSA): 25 mg/m² IV once weekly.

This medicine is given as an intravenous injection or infusion. Your doctor or nurse will give you this medicine. Kindly do not self administer.

Daunorubicin is an injection medicine given by healthcare professionals. You cannot miss a dose yourself. Do not miss your appointments with your doctor.

Common: Nausea, vomiting, low platelet count, ulcer, abdominal pain, loss of appetite, decreased white blood cell count, hair loss, fever, anemia, fatigue, chills, diarrhea, mucosal inflammation, febrile neutropenia, stomatitis, breathing problems.

Serious: Cardiotoxicity (heart muscle damage), myelosuppression, increased infection risk, secondary leukemia.

Regular cardiac function monitoring is required (risk of cardiotoxicity). Monitor complete blood count, kidney, liver and heart function. Caution in elderly, children and patients with hypertension. Caution with radiation therapy. Avoid live vaccines. Both partners should avoid pregnancy.

Heart failure; Pregnancy; Lactation.

Cyclophosphamide: Increased risk of cardiotoxicity.

Hepatotoxic drugs (high-dose methotrexate): Increased risk of hepatic toxicity.

Potentially Fatal: Immunization with live vaccines is not recommended. Concurrent radiation may lead to increased radiation reaction.

It is not known whether it is safe to consume alcohol with Daunorubicin. Please consult your doctor.

Pregnancy Category D. Daunorubicin is unsafe during pregnancy as there is definite evidence of risk to the developing baby. May be used in life-threatening situations if benefits outweigh risks.

Daunorubicin is unsafe during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

For pediatric patients (≥2 years or >0.5 m² BSA): 25 mg/m² once weekly. Safety in children <2 years has not been established.

Elderly patients have higher risk of cardiotoxicity; use with caution.

Renal impairment: Use with caution. Not recommended in severe kidney disease. If serum creatinine >3 mg/dL: 50% of regular dose.

Hepatic impairment: Use with caution. Not recommended in severe liver disease. If serum bilirubin >3 mg/dL: 50% of regular dose.

Overdose may lead to myelosuppression, cardiotoxicity, and gastrointestinal toxicity. Seek medical attention.

Store as per manufacturer's instructions. Usually below 25°C, protected from light.

Daunorubicin