What is it used for?
How does it work?
Daunorubicin is a type of chemotherapy medicine called a cytotoxic anthracycline antibiotic. It is used to treat cancer of the blood (leukaemia).
Cancers form when cells within the body multiply abnormally and uncontrollably. These cells spread, destroying nearby tissues. Daunorubicin works by stopping the cancer cells from multiplying. Its exact mechanism of action is unknown but it seems to work by inhibiting cell growth.
Daunorubicin inserts itself into the strands of genetic material (DNA) inside the cancerous cells and binds them together. This prevents the cells from making genetic material (DNA and RNA) and proteins. This prevents the cells from growing and therefore they die.
Unfortunately, daunorubicin can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells and hair cells. The most important side effect is on the bone marrow, where blood cells are made. Daunorubicin decreases the production of normal healthy blood cells, which can leave people susceptible to infection. Regular blood tests are needed to monitor the levels of blood cells.
In most chemotherapy regimens, doses are administered in courses at various intervals to allow normal cells to recover from the adverse effects of the anticancer medicines between doses. However, during this period, cancer cells will also recover and start to replicate again. Successful treatment depends on the administration of the next course of therapy before the cancer has re-grown to its previous size and the net effect is to decrease the amount of cancer with each successive course.
Daunorubicin is administered by injection or drip (infusion) into a vein.
- Chemotherapy medicines can decrease the number of blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell.
- Your doctor will want to monitor your heart, kidney and liver function before and during treatment with this medicine.
- This medicine may be harmful to an unborn baby, and for this reason you should use effective contraception to avoid becoming pregnant or fathering a child, both during treatment and for at least six months after treatment has finished. Women should consult their doctor immediately if they get pregnant during treatment.
- Your ability to get pregnant or father a child may be affected by treatment with this medicine. It is important to discuss fertility with your doctor before starting treatment.
- This medicine can cause severe reactions such as blistering and ulceration of the skin if it leaks out of the vein while it is being administered (extravasation). It is important to tell the person administering your medicine if you notice any leakage of fluid from your cannula site, or any burning or stinging around the vein while the medicine is being given.
Use with caution in
- Elderly people.
- People who are having or have recently had radiotherapy treatment, particularly in the area of the chest cavity.
- People who have had treatment with other medicines that may have side effects on the heart, eg other anthracycline chemotherapy medicines.
- Heart disease.
- Decreased liver function.
- Decreased kidney function.
Not to be used in
- People with severe infections.
- People with chickenpox (varicella zoster infection).
- People with shingles (herpes zoster).
- People with a severe reduction in blood cell production in the bone marrow, resulting in low levels of white blood cells or platelets in the blood (for example due to radiotherapy or previous courses of chemotherapy).
- People with severe irregular heartbeats (arrhythmias).
- People with heart failure or who have recently had a heart attack.
- Severely decreased liver function.
- Severely decreased kidney function.
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used in pregnancy, unless considered essential by your doctor due to life-threatening disease, because it is likely to be harmful to a developing baby.
- Women being treated with this medicine should use effective contraception to prevent pregnancy, and men being treated with this medicine should use effective contraception to avoid fathering a child, both during treatment, and for at least six months after treatment is finished. Consult your doctor immediately if you become pregnant.
- It is not known if this medicine passes into breast milk. However, if it does it is likely to be harmful to a nursing infant. Mothers who need treatment with this medicine should not breastfeed. Seek medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Decrease in the number of white blood cells in the blood (leukopenia and neutropenia).
- Decrease in the number of red blood cells in the blood count (anaemia).
- Reaction at site of injection such as redness.
- Inflammation of the wall of a vein (phlebitis).
- Reversible hair loss (alopecia).
- Red discoloration of urine. (This is due to the colour of the medicine and is normal. It usually lasts for one or two days only).
- Inflammation of the lining of the mouth (stomatitis).
- Inflammation of the mucous membranes in the intestinal tract (mucositis).
- Nausea and vomiting.
- Skin reactions such as rash, itching, redness, photosensitivity and changes in pigmentation of skin and nails.
- Loss of appetite.
- Hot flushes.
- Stopping of menstrual bleeding.
- Decreased sperm production.
- Raised uric acid levels in the blood.
- Heart problems such as heart failure, angina, heart attack, irregular heartbeats (arrhythmias).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines during treatment this one, to ensure that the combination is safe.
There may be an increased risk of side effects if this medicine is used in combination with other chemotherapy medicines, or other medicines that affect blood cell counts.
There is a higher risk of side effects on the heart if this medicine is used in combination with other medicines that can affect the heart, in particular the anti-cancer medicine trastuzumab. Your doctor will want to monitor your heart function more frequently if this is the case.
Chemotherapy decreases the body's immune response. This means that vaccines may be less effective if given during treatment, and live vaccines may cause serious infections. Live vaccines include: measles, mumps, rubella, MMR, oral polio, oral typhoid and yellow fever. If live vaccines are needed they should be postponed until at least six months after finishing chemotherapy.
Other medicines containing the same active ingredient