Daunorubicin is anthracycline chemotherapy agent used in the treatment of some cancers. It commonly administered as a treatment for acute myeloid leukemia and acute lymphatic leukemia. It is also a new treatment for Karposi’s sarcoma, an AIDS-related cancer of the skin and mouth but can also spread elsewhere. It works as a cytotoxic agent – preventing cancer cells from reproducing and eventually killing them off. It may also be used as part of a greater cancer treatment in combination with other drugs.
Daunorubicin is available as daunorubicin hydrochloride and daunorubicin citrate liposome. The liposomal formulation of the drug is structured such that the drug is contained within lipid (fat) molecules. This special formulation is able to penetrate body tissue and reach cancer cells easily because of its smaller size and special structure, remains longer in the body than daunorubicin citrate and is generally considered to be less prone to side effects. Daunorubicin’s liposomal formulation of is available as an injection under the brand name DaunoXome in the United States.
It is often prescribed as part of treatment for acute myeloid leukemia and acute lymphatic leukemia. It is also a recently-approved treatment for the rarer Karposi’s sarcoma.
To prepare daunorubicin for administration, the vial must be filled with 4 mL of sterile water for injection and slowly turned until the material has been completed dissolved in the water. Each vial can provide 20 mg of daunorubicin, and the desired dose is then drawn using a syringe already containing 10 to 15 mL of 0.9% sodium chloride solution and injected in a rapidly flowing 5% dextrose injection or 0.9% sodium chloride solution. Daunorubicin should not be administered with other drugs or with heparin.
Dosage of daunorubicin varies depending on condition as well as the patient’s age, body surface area and medical history.
For patients below 60 years of age suffering from acute nonlymphocytic leukemia, a dose of 45 mg/m²/day of daunorubicin IV infusion on the first 3 days of the first course of treatment and on the first 2 days of the succeeding courses. Aside from daunorubicin, another drug called cytosine arabinoside should also be administered in 100 mg/m²/day IV infusion dose each day for 7 days for the first course of treatment and for 5 days for the following courses of treatment.
But for patients 60 years old and above, the dose is lower at 30 mg/ m²/day IV infusion on the first 3 days of the initial treatment course and on first 2 days of the following courses. Cytosine arabinoside doses for the treatments remain similar to those administered to patients below 60 years of age.
Dosage for children also vary – and for children suffering from lymphocytic leukemia, a dose of 25 mg/m² daunorubicin IV infusion and vincristine 1.5 mg/m² should be given every first day of the week along with prednisone 40 mg/m2 PO every day. A complete remission of cancer may already be observed after four courses of this treatment, but if remission remains partial, an additional 2 courses may be administered to facilitate complete remission. For children younger than 2 years of age or those whose body surface area is below 0.5 m², it is recommended to measure doses of daunorubicin with respect to weight rather than body surface area.
Nausea and vomiting may be experienced soon after treatment and may last for 2 days. Complete or partial hair loss may also be experienced, usually starting 3 to 4 weeks into the treatment.
A dangerous side effect that may occur is the lowering of resistance against infections. If your feel a fever higher than 38 ºC (100.5 ºF) or feel generally unwell, seek immediate medical attention.
Other side effects include bruising and bleeding, changes in the color of urine and nails, sensitivity to the sun, fatigue and changes in taste.
Daunorubicin should only be administered through a vein along with other IV fluids, and must not be injected into muscle tissue or just underneath the skin. Do not inject into the spinal cavity either as it may cause serious nerve damage. Notify doctors if you observe any redness or experience pain, itching or swelling at or around the site of injection. Rarely, daunorubicin may also increase the risk for cardiovascular problems, which possibly includes heart failure, during or even months and years after completion of treatment.
Daunorubicin has the following structural formula:
• Molecular formula of daunorubicin is C27H29NO10
• Chemical IUPAC Name is 8-acetyl-10-(4-amino-5-hydroxy-6-methyl-tetrahydropyran-2-yl)oxy-6,8,11-trihydroxy-1- methoxy-7,8,9,10-tetrahydrotetracene-5,12-dione
• Molecular weight is 527.52 g/mol
Brand name(s): Acetyladriamycin, Anthracyline, Cerubidin, Cerubidine, Daunamycin, Daunarubicinum, Daunoblastin, Daunomycin, Daunorrubicina, Daunorubicine, Daunorubicinum, Daunoxome, Leukaemomycin C, Ondena, Rubidomycin, Rubomycin C
Review published on: 12 July 2009
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