Dactol

Dactol refers to cytotoxic antibiotics, which are intended for the treatment of cancer. The drug is potent, therefore, during the treatment, constant monitoring of the specialist is required. The maximum effective dosage, which will give a minimum of adverse reactions, should be calculated by a physician with sufficient experience in such treatment.

Indications Dactol

Dactol is assigned when:

• sarcoma Evings,
• trophoblastic disease of pregnant women,
• rhabdomyosarcoma,
• the Wilms tumor,
• non- seminiferous testicular carcinoma,
• as well as in relapsing or metastatic solid tumors.

[1], [2], [3], [4], [5], [6]

Release form

Dactol is available in the form of a powder, from which an injection solution is prepared. The carton contains one bottle of powder for a single dose.

[7], [8], [9]

Pharmacodynamics

Dactol refers to antitumor drugs from the group of actinomycins. The drug inhibits the multiplication of pathological cells, and also has an immunosuppressive effect.

[10], [11], [12], [13], [14], [15], [16], [17]

Pharmacokinetics

Dactol binds to tissue proteins, the metabolism of the drug in the body practically does not occur, the main active substance - dactinomycin - accumulates in nuclear cells, penetrates the placenta.

The half-life is 36 hours. Excretion from the body is slow (30% of the drug is excreted within seven days).

In the unchanged form, 50% of the drug is excreted with bile, 10% - with urine.

The drug does not penetrate the blood-brain barrier.

[18], [19]

Dosing and administration

Dactol is prescribed individually, depending on the size and location of the tumor, tolerability and treatment regimen.

The highest dose per day should not be more than 15 mg / kg body weight. When calculating the dosage, patients suffering from obesity, swelling take into account the dry weight of the body, i.е. Without regard to fat.

The dosage of the drug in childhood is not different.

The repeated course of treatment is carried out not earlier than three weeks, provided all the adverse reactions disappear.

To prepare the solution, you will need clean water for injection (1.1 ml). The powder dissolved in water is a concentrate (about 500 mg / ml), which should be added to isotonic solutions of glucose or sodium chloride. 

Dactol can be administered alone or simultaneously with other drugs that suppress tumor growth, and also be used as a supplement to surgical treatment. The drug can be passed through the vessels of the upper or lower extremities, which will significantly reduce the likelihood of side effects.

In the treatment of patients with obesity, as well as cases of chemotherapy or radiation in the past, smaller doses of the drug are recommended.

[27], [28], [29]

Use Dactol during pregnancy

Dactol is able to cause hereditary mutations, a violation of embryonic development, and also has a toxic effect on the embryo. Pregnant women can be prescribed Dactol by a doctor if the benefits of treatment for the mother are greater than the possible side effects for the fetus.

Data on the ability of the drug to penetrate into breast milk is not available, but given that most drugs are able to penetrate into breast milk, as well as severe adverse reactions in children, the appointment of Dactol should stop breastfeeding.

Contraindications

Dactol is contraindicated in cases of increased susceptibility of the organism to dactinomycin or other components of the drug.

Also, the drug is not used in chickenpox, herpes zoster, depressed bone marrow function, liver failure, elevated uric acid in the blood.

The drug is not prescribed for children under 6 months, pregnant and lactating women.

[20], [21], [22], [23], [24]

Side effects Dactol

Dactol has a toxic effect on the body. In the first weeks of treatment, only nausea and vomiting may appear, with time the condition may deteriorate significantly, but after treatment, the side effects disappear.

After the beginning of treatment, weakness, fever, calcium loss, growth retardation (in childhood), muscle pain, inflammation of the mucous membranes (mouth, throat, stomach, intestines), swallowing, pneumonia, abdominal pain, stool disorder may appear.

It is also often observed a violation of the liver, a decrease in hemoglobin, leukocytes, platelets, etc.

Skin rashes, acne, pigmentation of the skin (especially after irradiation) may appear.

With inaccurate administration, the drug can damage soft tissues, which can lead to swelling, redness, and decreased mobility of the joint.

[25], [26]

Overdose

Dactol, when exceeding the recommended dosage can provoke nausea, vomiting, upset of the stool, inflammation of the mucous membranes, severe inhibition of hematopoiesis, acute renal failure. If the drug is overdosed, a lethal outcome is possible.

In case of an overdose, symptomatic and supportive treatment is performed.

During the treatment should monitor the work of the kidneys, liver, bone marrow.

[30], [31], [32], [33]

Interactions with other drugs

Dactol in combination with other antitumor drugs, preparations of myelotoxic action or radiation therapy has a stronger therapeutic effect.

Simultaneous combination of Dactol with uricosoric drugs can provoke kidney damage.

Dactol with doxorubicin can enhance cardiotoxic action.

The effectiveness of vitamin K during treatment with Dactol may decrease. 

[34], [35]

Storage conditions

Dactol should be stored in a dry place, where direct sunlight does not reach. The drug should be stored at a temperature not higher than 25 ⁰ C and protected from children.

[36]

Special instructions

Dactol can distort the results of biological samples, which are assigned to detect the concentration of antibacterial substances in the blood plasma. Radiation therapy in combination with treatment with Dactol can lead to an increase in adverse reactions from the bone marrow and digestive system.

During treatment, it is necessary to monitor the functions of the liver, kidneys, the concentration of uric acid in the blood plasma.

Shelf life

Dactol is suitable for two years from the date of production, provided that the storage condition and the integrity of the packaging are not violated.

[37], [38]