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Daunorubicin Dosage

Medically reviewed on September 29, 2017.

Applies to the following strengths: 20 mg; 50 mg; 5 mg/mL

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

Renal Dose Adjustments

Serum Creatinine greater than 3 mg%: The dose should be 50% of the normal dose.

Liver Dose Adjustments

Serum bilirubin 1.2 to 3 mg/dL or AST 60-180 intl units: The dose should be reduced to 75% of the normal dose.
Serum bilirubin 3.1 to 5 mg/dL or AST greater than 180 intl units: The dose should be reduced to 50% of the normal dose.
Serum bilirubin greater than 5 mg/dL: Not recommended to be used.

Dose Adjustments

The dose of daunorubicin may also depend on whether other cytotoxic agents are to be given. Reference to specific protocols is recommended.

Precautions

US BOXED WARNINGS:
-This drug must be given into a rapidly flowing IV infusion. It must never be given by the IM or subcutaneous route. Severe local tissue necrosis will occur if there is extravasation during administration.
-Myocardial toxicity such as potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy. The incidence of myocardial toxicity increases after a total cumulative dose exceeding 400 to 550 mg/m2 in adults, 300 mg/m2 in children more than 2 years of age, or 10 mg/kg in children less than 2 years of age.
-Severe myelosuppression occurs when this drug is used in therapeutic doses; this may lead to infection or hemorrhage.
-This drug should be administered only by physicians who are experienced in leukemia chemotherapy in facilities equipped to monitor drug tolerance and toxicity. The physician and institution must be able to respond rapidly to severe hemorrhagic conditions and/or overwhelming infection.
-Dosage should be reduced in patients with impaired hepatic or renal function.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available.

Other Comments

The lifetime dosage of daunorubicin should not exceed 10 mg/kg in children less than 2 years of age, 300 mg/m2 in children greater than 2 years of age, and 400 to 600 mg/m2 in adults.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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