Dactinomycin Disease Interactions

The use of dactinomycin is contraindicated in patients with known or suspected varicella-zoster or herpes zoster infections. A severe, generalized, potentially fatal disease has been reported with dactinomycin use during or about the time of such infections. In addition, dactinomycin can induce myelosuppression, particularly when used with X-ray therapy. Therefore, dactinomycin therapy should be withheld, or given cautiously, in patients with an infection, depending on the severity. Close clinical monitoring of hematopoietic function is recommended whenever the drug is administered. If white blood cell and/or platelet counts are markedly decreased, therapy should be withheld to allow marrow recovery, which often takes up to three weeks.

Hepatotoxicity can occur with the use of dactinomycin for injection. Monitor AST, ALT, alkaline phosphatase, and bilirubin prior to and during dactinomycin therapy. Caution is advised if used in patients with preexisting liver disease.

The safety with live viral vaccines following dactinomycin for injection has not been studied and vaccination with live virus vaccines is not recommended before or during treatment.

Severe and fatal myelosuppression, which may include neutropenia, thrombocytopenia and anemia, can occur with dactinomycin. If either the white blood cell or platelet count is markedly decreased, therapy with dactinomycin should be withheld or dose should be reduced to allow recovery. Therapy with dactinomycin should be administered cautiously in patients with myelosuppression. Close clinical monitoring of hematopoietic function is recommended.

Abnormalities of renal function can occur with dactinomycin for injection. Monitor creatinine and electrolytes frequently during dactinomycin therapy. Caution is advised if used in patients with preexisting renal disease.