Your child needs to take the medicine called amsacrine (say: AM-sah-kreen). This information sheet explains what amsacrine does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is amsacrine?
Amsacrine is a medicine used to treat leukemia. It interferes with the growth of cancer cells, which are then eventually destroyed by the body.
You may hear amsacrine called m-AMSA, acridinyl anisidide or by its brand name, AMSA PD. Amsacrine comes in injection form.
Before giving amsacrine to your child
Tell your child's doctor if your child has ever reacted badly to amsacrine or any other drug, food, preservatives, or colouring agents.
Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medication if your child has:
- low blood counts.
- heart rhythm problems.
- infection or recent exposure to infection (for example, chickenpox).
- kidney or liver problems.
How will your child get amsacrine?
Amsacrine is an orange-red liquid given as an injection (needle) into your child's vein. This is done in the hospital clinic or on the nursing unit.
If amsacrine leaks out of the vein through which it is being given, it may cause severe damage and scarring. This may happen while your child is getting amsacrine or afterwards. Tell the doctor or 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 amsacrine?
Your child may have some of these side effects while they take amsacrine. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:
- nausea (upset stomach) or vomiting (throwing up)
- sores in mouth or on lips
- diarrhea (loose, watery stools)
- hair loss
- burning, numbness, "pins and needles", or tingling feelings
- orange-coloured urine (common for a few days after amsacrine)
- headache
Call your child's doctor during office hours if your child has any of these side effects:
- unusual tiredness or weakness
- yellow eyes or skin
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 the Emergency Department if your child has any of these side effects:
- fever, chills, cough, sore throat
- easy bruising or bleeding
- vomiting of blood or material that looks like coffee grounds
- black tarry stools
- blood in the urine
- painful or difficult urination
- lower back or side pain
- fast or irregular or uneven heartbeat
- dizziness, feeling faint or lightheadedness
- seizures
- pain or swelling around the rectum
- tightness of the throat, trouble breathing, itchiness, or redness during the time the drug is being given into the vein
- symptoms of an allergic reaction: rash, hives, shortness of breath, chest tightness, or swelling of the mouth, face, lips, tongue, or throat
- symptoms of low potassium levels: muscle pain or weakness, muscle cramps
What safety measures should you take when your child is using amsacrine?
Your child may lose their hair. It will grow back once your child is no longer receiving amsacrine. Its colour and texture may change. Use a gentle shampoo and a soft brush.
Amsacrine may cause changes in heart rhythm in some people. Your child's heart may be monitored while they are getting amsacrine.
Amsacrine 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/your child shouldn't touch your child's eyes or inside their nose without washing yours/their hands first.
- Your child's nurse will review with you what to do in case of fever.
Amsacrine 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.
- Your child should avoid contact sports where bruising or injury could occur.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking amsacrine.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or 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.
Amsacrine 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 as it may sting and cause dry mouth.
There is a chance that amsacrine 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 amsacrine. Tell the doctor right away if your child may be pregnant.
After receiving amsacrine, your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with you/your child.
Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products). The medicines listed below may interact with the amsacrine as well, but this list is not complete.
- Acetylsalicyclic acid (Aspirin)
- Ibuprofen (Advil)
- Blood thinners
What other important information should you know about amsacrine?
- Your child will receive medicine to prevent upset stomach and throwing up caused by amsacrine
- Keep a list of all medications your child is on to show the doctor or pharmacist
- Do not share your child’s medicine with others and do not give anyone else’s medicine to your child
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines
Keep amsacrine out of your child’s sight and reach and locked up in a safe place. If your child takes too much amsacrine, 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.