How does this medication work? What will it do for me?

Daunorubicin belongs to the group of cancer-fighting medicines known as antineoplastics, and specifically to the family of antineoplastics called anthracyclines. Another anthracycline is doxorubicin.

Daunorubicin is used alone or in combination with other antineoplastic medications for the treatment of many types of cancer including cancers of the blood (e.g., leukemia), lymphosarcoma, reticulosarcoma, Wilm's tumour, and Ewing tumours.

Daunorubicin causes the death of cancer cells by interfering with the genetic material DNA, which is necessary for reproduction and growth of cells.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

This medication is available as 20 mg/vial powder for solution injection.

How should I use this medication?

The recommended dose and dosing schedule of daunorubicin varies widely according to the specific disease being treated, the response to therapy, and the other medications being used. The dose administered is also based on body weight or body size. In children the administered dose is based on body weight.

Daunorubicin is usually injected into a vein through a specially prepared site on your skin. Very careful handling of this medication is required. It is always given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.

As well as interfering with the genetic material DNA of cancer cells, daunorubicin can interfere with some of your normal cells. This can cause a number of side effects such as hair loss and mouth sores. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to daunorubicin or any ingredients of this medication
  • are breast-feeding
  • have already been treated with the maximum allowable lifetime dose of any anthracycline drug (daunorubicin, doxorubicin, epirubicin, idarubicin) or mitoxantrone
  • have heart failure
  • have low blood cell counts caused by previous cancer drug treatment or radiation therapy

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • darkening of soles, palms, or nails
  • diarrhea
  • hot flashes
  • nausea and vomiting
  • reddish-coloured urine (not blood) - this is normal, and lasts 1 to 2 days after each dose
  • reduction in number of menstrual periods
  • temporary total loss of hair (returns after treatments end)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • skin rash or itching
  • sores in mouth and on lips

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • black, tarry stools
  • blood in urine
  • cough or hoarseness with fever or chills
  • fever or chills
  • irregular heartbeat or palpitations in the chest
  • lower back or side pain with fever or chills
  • pain at injection site
  • painful or difficult urination with fever or chills
  • pinpoint red spots on skin
  • shortness of breath or swelling of the lips, tongue, or face
  • swelling of feet and lower legs
  • unusual bleeding or bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.

Gout and kidney stones: Daunorubicin may increase the levels of uric acid in the body, further increasing the risk for gout or kidney stones in people predisposed to these conditions.

Heart disease: The risk of abnormal heart rhythm, congestive heart failure, and a weakened heart (cardiomyopathy) is increased in people with preexisting heart disease.

Infection: As well as killing cancer cells, this medication can reduce the number of cells in the body that can fight infection (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills. Discuss any vaccines with your doctor before getting vaccinated.

Pregnancy: There is a possibility of birth defect if either the man or woman is using daunorubicin at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using this medication. This medication may harm the baby if used during pregnancy. Tell your doctor immediately if you become pregnant while using this medication.

Breast-feeding: Women should not breast-feed while receiving daunorubicin treatment due to risk of potential harm to the infant.

What other drugs could interact with this medication?

There may be an interaction between daunorubicin and any of the following:

  • amphotericin B
  • azathioprine
  • colchicine
  • flucytosine
  • ganciclovir
  • interferon
  • plicamycin
  • probenecid
  • other cancer drugs, especially anthracyclines
  • sulfinpyrazone
  • vaccines
  • zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.