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daunorubicin

Generic Name: daunorubicin (DAW noe ROO bi sin)
Brand Name: Cerubidine

What is daunorubicin?

Daunorubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Daunorubicin is used in the treatment of leukemia (blood cancer).

Daunorubicin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about daunorubicin?

Daunorubicin may cause dangerous effects on your heart. Call your doctor at once if you have chest pain, shortness of breath (even with mild exertion), swelling, or rapid weight gain.

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Daunorubicin can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

What should I discuss with my healthcare provider before using daunorubicin?

You should not use daunorubicin if you are allergic to it.

To make sure daunorubicin is safe for you, tell your doctor if you have:

  • heart disease;

  • kidney disease;

  • liver disease;

  • a weak immune system (caused by disease or by using certain medicines); or

  • if you have ever been treated with doxorubicin, epirubicin, idarubicin, mitoxantrone, or liposomal daunorubicin (Daunoxome).

Using daunorubicin may increase your risk of developing other types of leukemia. Ask your doctor about your specific risk.

FDA pregnancy category D. Do not use daunorubicin if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether daunorubicin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I use daunorubicin?

Daunorubicin is injected into a vein through an IV. A healthcare provider will give you this injection.

Before you receive each dose of daunorubicin, your heart function may need to be checked with an electrocardiograph or ECG (sometimes called an EKG). Your kidney and liver function may also need to be checked.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when daunorubicin is injected.

Skin accidentally exposed to daunorubicin should be rinsed thoroughly with soap and warm water.

Daunorubicin can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your daunorubicin injection.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while using daunorubicin?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Daunorubicin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • chest pain, shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • pain, burning, irritation, or skin changes where the injection was given.

Common side effects may include:

  • mild nausea, vomiting, diarrhea, stomach pain;

  • temporary hair loss, mild itching or rash; or

  • red colored urine for 1 or 2 days following a dose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Daunorubicin Dosing Information

Usual Adult Dose for Acute Nonlymphocytic Leukemia:

Under 60 years of age: 45 mg/m2 IV over 2 to 5 minutes once a day on days 1, 2, and 3 for the first course and on days 1 and 2 for subsequent courses) with cytosine arabinoside (ara-C) intravenously once a day (usually for 7 days for the first course and 5 days for subsequent courses) as remission induction therapy.

Usual Adult Dose for Acute Lymphocytic Leukemia:

For Remission Induction:

45 mg/m2/day IV on days 1, 2, and 3 (along with vincristine, prednisone, and L-asparginase therapy)

Usual Geriatric Dose for Acute Nonlymphocytic Leukemia:

Greater than or equal to 60 years of age: 30 mg/m2 IV over 2-5 minutes once a day on days 1, 2, and 3 for the first course and on days 1 and 2 for subsequent courses) with cytosine arabinoside (ara-C) intravenously once a day (usually for 7 days for the first course and 5 days for subsequent courses) as remission induction therapy.

Usual Pediatric Dose for Acute Myeloid Leukemia:

As a part of combination therapy: Induction:
30 to 60 mg/m2/day by continuous IV infusion on days 1 to 3 of cycle

or

20 mg/m2/day for 4 days every 14 days

Usual Pediatric Dose for Acute Lymphocytic Leukemia:

Acute Lymphocytic Leukemia combination therapy: Remission Induction:

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

greater than 2 years or greater than 0.5 m2:
25 mg/m2 IV on day 1 every week (along with vincristine and prednisolone therapy). Generally complete remission will be obtained after 4 courses of therapy. If needed, an additional 1 or 2 courses of therapy may be administered in an effort to obtain a complete remission.

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

What other drugs will affect daunorubicin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with daunorubicin, especially:

  • acetaminophen (Tylenol);

  • leflunomide, teriflunomide;

  • methotrexate;

  • an antibiotic, antifungal medicine, sulfa drug, or tuberculosis medicine;

  • birth control pills or hormone replacement therapy;

  • cholesterol-lowering medications--Crestor, Lipitor, Pravachol, Simcor, Vytorin, Zocor, and others;

  • drugs that weaken the immune system, such as cancer medicine, steroids, and medicines to prevent organ transplant rejection;

  • gout or arthritis medications (including gold injections);

  • heart or blood pressure medication;

  • HIV/AIDS medications;

  • medicines to treat mental illness;

  • an NSAID (non-steroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, others; or

  • seizure medication--carbamazepine, phenytoin, and others.

This list is not complete. Other drugs may interact with daunorubicin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about daunorubicin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.02. Revision Date: 2013-07-01, 2:45:55 PM.

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