Dactinomycin
Trade Names:
Actinomycin D, Cosmegen, Act-D
Type of Drug:
Dactinomycin belongs to the general group of chemotherapy drugs known as antibiotics. It is used to treat testicular, ovarian, and germ cell cancers.
How Drug Works:
Dactinomycin stops the growth of cancer cells, causing the cells to die.
How Drug Is Given:
Dactinomycin is given as a shot in a vein over about 15 minutes. Tell the nurse if you feel pain, burning, or discomfort in the vein when the medicine is given. You will get medicine to stop any nausea or vomiting before the dactinomycin and to take afterward. The dose and how often you get the medicine depends upon your size, your blood counts, and the type of cancer being treated. You will have your blood counts checked before each treatment; if they are too low, your treatment will be delayed. This medicine may be given in addition to other anticancer medicines.
Read the following information. If you do not understand it or if any of it causes you special concern, check with your doctor.

Before taking this drug, tell your doctor:

  • If you are trying to become pregnant, are pregnant, or breastfeeding. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. However, do not use oral contraceptives (“the pill”) without checking with your doctor.

  • If you think you may want to have children in the future. Many chemotherapy drugs can cause sterility.

  • If you have any of the following medical problems: chickenpox or exposure to chickenpox, gout, heart disease, congestive heart failure, shingles, kidney stones, liver disease, or other forms of cancer.

  • If you are taking any other prescription or over-the-counter drugs, including vitamins and herbals.
Should I avoid any other medicines, foods, alcohol, and/or activities?
Your prescription and nonprescription medicines may interact with other drugs, causing harm. Certain foods or alcohol can also interact with drug products. Never begin taking a new medicine—prescription or nonprescription—without asking your doctor or nurse if it will interact with alcohol, food, or other medicines. Some drug products can cause drowsiness and affect activities such as driving.
Precautions:
While you are being treated with dactinomycin, and after you stop treatment, do not have any immunizations (vaccinations) without your doctor’s okay. Try to avoid contact with people who have recently taken the oral polio vaccine. Check with your doctor about this.
Dactinomycin can lower your blood counts (white blood cells, red blood cells, platelets). Your doctor will check your blood counts before and after each treatment to see its effect on your blood counts. Your doctor or nurse will give you specific instructions if your blood counts are low.
Dactinomycin can decrease your white blood cell count, especially 7 to 10 days after the drug is given. This can increase your risk of getting an infection. Report fever of 100.5°F or higher, or signs of infection such as pain in passing your urine, coughing, and bringing up sputum.
Dactinomycin can decrease your platelet count. This can increase your risk of bleeding. DO NOT take any aspirin or aspirin-containing medicines. Report unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
Dactinomycin is given intravenously. If the drug accidentally leaks out of the vein where it is given, it may damage the tissue and cause scarring. Tell the nurse right away if you notice redness, pain, or swelling at the place of injection.
Getting a wig before starting treatment may make it easier to deal with hair loss. Talk to your nurse or doctor about this. If your insurance does not cover it, there may be other resources to help you. Hair loss is temporary, and your hair will grow back after treatment.
Dactinomycin can cause radiation recall. When a person has had radiation therapy and then receives this drug, the skin or tissue damage from prior radiation therapy can become red and appear damaged again. Tell your doctor or nurse if your skin gets red in areas where radiation was given.
Dactinomycin can cause severe nausea and vomiting. Ask your doctor or nurse to give you medicines to prevent or lessen this.
Tell all the doctors, dentists, and pharmacists you visit that you are taking this drug.
  • Most of the following side effects probably will not occur.
  • Your doctor or nurse will want to discuss specific care instructions with you.
  • They can help you understand these side effects and help you deal with them.
Side Effects:
More Common Side Effects
  • Decreased white blood cell count with increased risk of infection
  • Vomiting
  • Loss of appetite
  • Decreased platelet count with increased risk of bleeding
  • Sores in mouth or on lips, esophagus, or rectal area
  • Darkening of skin along vein used for giving the drug
  • Diarrhea
  • Rash
  • Hair loss
  • Radiation recall skin changes
  • Nausea
Less Common Side Effects
  • Tiredness (fatigue)
  • Abdominal pain
  • Fever
  • Fetal abnormalities if taken while you are pregnant or if you become pregnant while taking this drug
  • Muscle and bone aches
  • Depression
Rare Side Effects
  • Liver damage
  • Kidney damage
Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop any problems.
FDA Approval: This drug is approved for cancer treatment.