Dactinomycin (Page 3 of 3)
12.2 Pharmacodynamics
Dactinomycin exposure-response relationships and the time course of pharmacodynamics response are unknown.
12.3 Pharmacokinetics
The distribution and excretion of radiolabeled dactinomycin (3 H actinomycin D) were assessed in three adult patients with malignant melanoma.
Distribution
3 H actinomycin D is concentrated in nucleated cells and does not penetrate the blood-brain barrier.
Elimination
Excretion
Following administration of radiolabeled dactinomycin, approximately 30% was recovered in urine and feces in one week.
Specific Populations
Pediatric Patients
Published studies and population analyses in patients ≤ 21 years of age with cancer report a trend of increasing systemic dactinomycin clearance with increasing body weight.
Drug Interaction Studies
Published in vitro studies report that dactinomycin may be a substrate of the P-glycoprotein and OATP1B3 transporter systems.
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
Dactinomycin is a carcinogen in animals. Local sarcomas were produced in mice and rats after repeated subcutaneous or intraperitoneal injections. Mesenchymal tumors occurred in male rats given intraperitoneal injections of 50 mcg/kg, 2 to 5 times per week, for 18 weeks, at doses (based on body surface area) 0.5 times the clinical dose of 1,250 mcg/m2.
Dactinomycin was mutagenic in several in vitro and in vivo test systems including human fibroblasts and leukocytes, and HeLa cells. DNA damage and cytogenetic effects have been demonstrated in the mouse and the rat.
15 REFERENCES
1. “OSHA Hazardous Drugs.” OSHA. http://www.osha.gov/SLTC/hazardousdrugs/index.html
16 HOW SUPPLIED/STORAGE AND HANDLING
Dactinomycin for Injection, USP for intravenous use is an amorphous yellow to orange powder. Each vial contains 500 mcg (0.5 mg) of dactinomycin and 20 mg of mannitol. It is supplied as follows:
NDC | Dactinomycin for Injection, USP (500 mcg per vial) | Package Factor |
71288-129 -02 | 500 mcg Single-Dose Vial | 1 vial per carton |
Storage Conditions
Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° to 30°C (59° to 86°F). [See USP Controlled Room Temperature.]
Protect from light and humidity.
Store the reconstituted Dactinomycin for Injection, USP at room temperature for no more than 4 hours from reconstitution to completion of administration [see Dosage and Administration (2.7)].
Dactinomycin for Injection, USP is a cytotoxic drug. Follow applicable special handling and disposal procedures.1
Discard unused portion.
Lyophilized.
Sterile, Nonpyrogenic, Preservative-free. The container closure is not made with natural rubber latex.
17 PATIENT COUNSELING INFORMATION
Secondary Malignancy or Leukemia
Advise patients of the increased risk of secondary malignancies [see Warnings and Precautions (5.1)].
Veno-occlusive Disease
Advise patients about the symptoms of VOD and to seek medical attention if they develop new onset jaundice, abdominal distention, or right upper quadrant pain [see Warnings and Precautions (5.2)].
Myelosuppression
Advise patients to contact their healthcare provider for any signs or symptoms of myelosuppression or infection [see Warnings and Precautions (5.4)].
Severe Mucocutaneous Reactions
Advise patients of the risk of severe mucocutaneous reactions and to contact their health care provided for new skin lesions, mouth sores or oropharyngeal lesions [see Warnings and Precautions (5.5)].
Renal Toxicity or Hepatotoxicity
Advise patients of the need for periodic laboratory testing to monitor for renal toxicity and hepatotoxicity [see Warnings and Precautions (5.7, 5.8)].
Potentiation of Radiation Toxicity and Radiation Recall
Advise patients of the risk of increased radiation-induced gastrointestinal, myelosuppression and skin toxicity [see Warnings and Precautions (5.9)].
Embryo-Fetal Toxicity
Advise females of reproductive potential of the potential risk to a fetus. Advise females to inform their healthcare provider of a known or suspected pregnancy [see Warnings and Precautions (5.10), Use in Specific Populations (8.1)].
Advise females of reproductive potential to use effective contraception during treatment with dactinomycin and for 6 months after final dose [see Use in Specific Populations (8.3)].
Advise male patients with female partners of reproductive potential to use effective contraception during treatment with dactinomycin and for 3 months after final dose [see Use in Specific Populations (8.3)].
Lactation
Advise females not to breastfeed during treatment with dactinomycin and for 14 days after the final dose [see Use in Specific Populations (8.2)].
meitheal®
Mfd. for Meitheal Pharmaceuticals
Chicago, IL 60631 (USA)
©2020 Meitheal Pharmaceuticals Inc.
August 2020
Principal Display Panel – Dactinomycin for Injection, USP 500 mcg Vial Label
NDC 71288-129 -02
Rx Only
Dactinomycin for Injection, USP
500 mcg (0.5 mg) per vial
For Preparation of Intravenous Solutions
Caution: Cytotoxic Agent
Single-Dose Vial
Principal Display Panel – Dactinomycin for Injection, USP 500 mcg Carton
NDC 71288-129 -02
Rx Only
1 Single-Dose Vial
Dactinomycin for Injection, USP
500 mcg (0.5 mg) per vial
For Preparation of Intravenous Solutions
Caution: Cytotoxic Agent
DACTINOMYCIN dactinomycin injection, powder, lyophilized, for solution | |||||||||||||||||
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Labeler — Meitheal Pharmaceuticals Inc. (080548348) |
Establishment | |||
Name | Address | ID/FEI | Operations |
Kindos Pharmaceuticals Co., Ltd. | 529111185 | MANUFACTURE (71288-129) |
Revised: 11/2020 Meitheal Pharmaceuticals Inc.
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