Dactinomycin

Dactinomycin
Clinical data
Trade names	Cosmegen
Other names	Actinomycin C1; Actinomycin D; Actinomycin IV; Meractinomycin;
AHFS/Drugs.com	Monograph
MedlinePlus	a682224
Pregnancy; category	AU: D;
Routes of; administration	IV
ATC code	L01DA01 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); CA: ℞-only; UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Protein binding	5%
Metabolism	hepatic
Elimination half-life	36 hours
Excretion	Bile
Identifiers
	IUPAC name 2-Amino-N,N′- bis[(6S,9R,10S,13R,18aS)-6,13-diisopropyl-2,5,9-trimethyl-1,4,7,11,14-pentaoxohexadecahydro-1H-pyrrolo[2,1-i][1,4,7,10,13]oxatetraazacyclohexadecin-10-yl]-4,6-dimethyl-3-oxo-3H-phenoxazine-1,9-dicarboxamide;
CAS Number	50-76-0 ;
PubChem CID	457193;
DrugBank	DB00970 ;
ChemSpider	10482167 ;
UNII	1CC1JFE158;
KEGG	C06770 ;
ChEBI	CHEBI:27666 ;
ChEMBL	ChEMBL1554 ;
NIAID ChemDB	009885;
CompTox Dashboard (EPA)	DTXSID9020031 ;
ECHA InfoCard	100.000.058
Chemical and physical data
Formula	C62H86N12O16
Molar mass	1255.438 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES Cc1c2oc3c(C)ccc(C(O)=N[C@@H]4C(O)=N[C@H](C(C)C)C(=O)N5CCC[C@H]5C(=O)N(C)CC(=O)N(C)[C@@H](C(C)C)C(=O)O[C@@H]4C)c3nc-2c(C(O)=N[C@@H]2C(O)=N[C@H](C(C)C)C(=O)N3CCC[C@H]3C(=O)N(C)CC(=O)N(C)[C@@H](C(C)C)C(=O)O[C@@H]2C)c(N)c1=O;
	InChI InChI=1S/C62H86N12O16/c1-27(2)42-59(84)73-23-17-19-36(73)57(82)69(13)25-38(75)71(15)48(29(5)6)61(86)88-33(11)44(55(80)65-42)67-53(78)35-22-21-31(9)51-46(35)64-47-40(41(63)50(77)32(10)52(47)90-51)54(79)68-45-34(12)89-62(87)49(30(7)8)72(16)39(76)26-70(14)58(83)37-20-18-24-74(37)60(85)43(28(3)4)66-56(45)81/h21-22,27-30,33-34,36-37,42-45,48-49H,17-20,23-26,63H2,1-16H3,(H,65,80)(H,66,81)(H,67,78)(H,68,79)/t33-,34-,36+,37+,42-,43-,44+,45+,48+,49+/m1/s1 ; Key:RJURFGZVJUQBHK-IIXSONLDSA-N ;
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Dactinomycin, also known as actinomycin D, is a chemotherapy medication used to treat a number of types of cancer.^[2] This includes Wilms tumor, rhabdomyosarcoma, Ewing's sarcoma, trophoblastic neoplasm, testicular cancer, and certain types of ovarian cancer.^[2] It is given by injection into a vein.^[2]

Most people develop side effects.^[2] Common side effects include bone marrow suppression, vomiting, mouth ulcers, hair loss, liver problems, infections, and muscle pains.^[2] Other serious side effects include future cancers, allergic reactions, and tissue death if extravasation occurs.^[2] Use in pregnancy may harm the baby.^[2] Dactinomycin is in the cytotoxic antibiotic family of medications.^[3] It is believed to work by blocking the creation of RNA.^[2]

Dactinomycin was approved for medical use in the United States in 1964.^[2] It is on the 2023 World Health Organization's List of Essential Medicines.^[4]

^ Kwok KK, Vincent EC, Gibson JN (2017). Pharmacology and Therapeutics for Dentistry. Mosby. pp. 530–562. doi:10.1016/B978-0-323-39307-2.00036-9.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ "Dactinomycin". The American Society of Health-System Pharmacists. Archived from the original on 11 September 2017. Retrieved 8 December 2016.
^ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 582. ISBN 9780857111562.
^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.

[1] Kwok KK, Vincent EC, Gibson JN (2017). Pharmacology and Therapeutics for Dentistry. Mosby. pp. 530–562. doi:10.1016/B978-0-323-39307-2.00036-9.

[AHFS2016-2] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ "Dactinomycin". The American Society of Health-System Pharmacists. Archived from the original on 11 September 2017. Retrieved 8 December 2016.

[BNF69-3] British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 582. ISBN 9780857111562.

[WHO23rd-4] World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.

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