Your child needs to take the medicine called dactinomycin (say: dak-ti-noe-MYE-sin). This information sheet explains what dactinomycin does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is dactinomycin?
Dactinomycin is a medicine that interferes with the growth of cancer cells. You may hear dactinomycin called Actinomycin D or by its brand name, Cosmegen. Dactinomycin comes in injection form.
Before giving dactinomycin to your child
Tell your child's doctor if your child has:
- ever reacted badly to dactinomycin, any component of the medication or to any other medication, food, preservative or colouring agent
- been recently exposed to chickenpox or could have chickenpox or herpes zoster (shingles)
Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- had past cancer or radiation treatment that the doctor may not already know about
- any kind of infection
- liver problems
How will your child receive dactinomycin?
Dactinomycin is a clear, yellow-gold liquid given by needle into your child's vein (intravenously or IV). Usually your child will get this medicine in the hospital clinic or on a nursing unit.
If dactinomycin leaks out of the vein through which it is being given, it can cause severe damage. Tell the nurse right away if you or your child notice redness, pain, or swelling at the place of injection.
What are the possible side effects of dactinomycin?
Your child may have some of these side effects while they take dactinomycin. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or if they bother your child:
- feeling tired or weak
- nausea (upset stomach) and vomiting (throwing up)
- redness of skin
- mild skin rash
- acne
- darkening of skin (if your child had any radiation therapy)
Call your child's doctor during office hours if your child has any of these side effects:
- sores on the mouth, lips, tongue or throat
- unusual tiredness or weakness
- yellow eyes or skin
- swelling in the feet or legs
- diarrhea (watery bowel movements)
- stomach pain
- bad skin rash
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- pain, redness, or swelling at the place of injection
- unusual bleeding or bruising
- black tarry stools
- blood in urine or stools
- fever or chills
- sore throat
- cough or hoarseness
- lower back or side pain
- pain or trouble with urinating
- trouble breathing, shortness of breath, or wheezing
- swelling of the face
- rash over the whole body
What safety measures should you take when your child is using dactinomycin?
Your child will receive medicine to prevent upset stomach and throwing up caused by dactinomycin.
Dactinomycin may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store-bought mouthwash that contains alcohol, as it may sting and cause dry mouth.
Your child may lose their hair. It will grow back once your child is no longer receiving dactinomycin. Its colour and texture may change. Use a gentle shampoo and a soft brush.
Dactinomycin can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse, or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child should not touch your child's eyes or inside their nose without washing hands first.
- Your child's nurse will review with you what to do in case of fever.
Dactinomycin can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Your child should not receive a permanent tattoo or any kind of body piercing.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking dactinomycin.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child and anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps and rubella (MMR) and chickenpox vaccine.
There is a chance that dactinomycin may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving dactinomycin. Tell the doctor right away if your child may be pregnant.
After your child stops receiving dactinomycin, it may still cause side effects. These delayed effects may include certain types of cancer. Check with your doctor immediately if any of the following signs occur, even after dactinomycin treatment has stopped:
- yellow eyes or skin
- black tarry stools
- blood in urine or stool
- lower back or side pain
- stomach pain
- cough or a hoarse voice
- unusual bleeding or bruising
- diarrhea
Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
Keep dactinomycin out of your child’s sight and reach and locked up in a safe place. If your child takes too much dactinomycin, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.