#高警訊藥品

淋巴瘤、急性骨髓性白血病 Acute lymphoid leukemia; Acute myeloid leukemia

Antineoplastic Agent (Anthracycline; Topoisomerase II Inhibitor)
Daunorubicin inhibits DNA and RNA synthesis by intercalation between DNA base pairs and by steric obstruction. Daunomycin intercalates at points of local uncoiling of the double helix. Although the exact mechanism is unclear, it appears that direct binding to DNA (intercalation) and inhibition of DNA repair (topoisomerase II inhibition) result in blockade of DNA and RNA synthesis and fragmentation of DNA.

Distribution:
Distributes widely into tissues, particularly the liver, kidneys, lung, spleen, and heart; does not distribute into the CNS
Metabolism:
Primarily hepatic to daunorubicinol (active), then to inactive aglycones, conjugated sulfates, and glucuronides
Half-life elimination:
1. Initial: 45 minutes; Terminal: 18.5 hours
2. Daunorubicinol plasma half-life: ~27 hours
Excretion:
Feces (40%); urine (~25% as unchanged drug and metabolites)

Hypersensitivity to daunorubicin or any component of the product.

Based on data from animal reproduction studies, in utero exposure to daunorubicin may cause fetal harm.

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer recommends that breastfeeding be discontinued during daunorubicin therapy.

Alopecia, Nausea and vomiting, Cardiotoxicity, Hyperuricemia, Myelosuppression

General dose:
1. Initial dose: IV 1mg/ky/day for 4-5 days, monitor closely; then restart treatment after 8-10 days
2. Maintenance dose: IV 1-2mg/kg once to twice every week

SCr >3 mg/dL: Administer 50% of normal dose

1. Serum bilirubin 1.2-3 mg/dL: Administer 75% of dose
2. Serum bilirubin >3 mg/dL: Administer 50% of dose