Daunobin Injection 20 mg

Indications

Daunorubicin is a cancer medicine used mainly to treat acute leukaemias, especially acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL), usually together with other anticancer medicines to bring the disease into remission.

How It Works

Daunorubicin belongs to the anthracycline group. It slips between the strands of DNA in cancer cells and blocks an enzyme called topoisomerase II, which cells need to copy their DNA. This stops cancer cells from dividing and causes them to die. It also affects some fast-growing healthy cells, which explains many of its side effects.

Dosage and Administration

Daunorubicin is given only in hospital by a doctor or nurse experienced in cancer treatment, as an injection or infusion into a vein. The dose, number of days and treatment cycles are worked out by the specialist from body surface area, blood counts, heart, liver and kidney function, and the total amount of anthracycline already received. It must never be injected into a muscle or under the skin.

Interactions

Other medicines that harm the heart, such as Doxorubicin, Trastuzumab or high-dose Cyclophosphamide, or radiotherapy to the chest, increase the risk of heart damage. Other medicines that lower blood counts add to its effect on the bone marrow. Medicines that affect the liver can change how it is cleared. Live vaccines must be avoided during and after treatment. Tell the care team about every medicine and supplement you take.

Contraindications

It should not be given to people with severe heart failure or recent heart attack, severe bone marrow suppression, severe liver or kidney impairment, a serious uncontrolled infection, previous treatment with the maximum safe lifetime dose of anthracyclines, or allergy to daunorubicin.

Side Effects

Common side effects include:

• Low blood counts, raising the risk of infection, bleeding and anaemia
• Nausea, vomiting, mouth sores and diarrhoea
• Hair loss (usually grows back after treatment)
• Red coloured urine for 1 to 2 days after a dose (harmless)
• Tiredness and fever

Serious effects include heart muscle damage (which can appear months or years later), and severe tissue damage if the drug leaks out of the vein at the injection site.

Get urgent medical help if you have fever of 38°C or more, chills, unusual bleeding or bruising, shortness of breath, swelling of the legs, a fast or irregular heartbeat, or pain, burning or swelling at the drip site.

Pregnancy and Lactation

Daunorubicin can harm an unborn baby. Women and men should use reliable contraception during treatment and for several months afterwards, as advised by the specialist. Breastfeeding must be stopped during treatment.

Precautions and Warnings

Heart function is checked before and during treatment, and blood counts, liver and kidney tests are monitored closely. Tell your doctor about any heart disease or previous chest radiotherapy. Drink plenty of fluids as advised to help protect the kidneys from tumour breakdown products (tumour lysis). Avoid people with infections and practise good mouth care.

Overdose

Overdose can cause severe bone marrow suppression, mouth and gut damage and heart problems. It is managed in hospital with supportive care, including transfusions, antibiotics and heart monitoring.

Therapeutic Class

Antineoplastic (anticancer) agent; anthracycline antibiotic.

Storage

Store as directed on the pack. It is a hospital medicine kept and prepared by the pharmacy or ward staff, away from light and out of the reach of children.