Daunorubicin

Daunorubicin is a prescription medication used to treat certain types of blood cancer. Daunorubicin belongs to a group of drugs called anthracyclines. These help by slowing down or stopping the growth of cancerous cells in your body.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional. 

Common side effects of daunorubicin include nausea, vomiting, diarrhea, and red urine.

Daunorubicin is a prescription medication used to treat certain types of blood cancer, such as leukemia, in combination with other approved anticancer drugs. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Daunorubicin may be found in some form under the following brand names:

• Cerubidine

Serious side effects have been reported with daunorubicin. See the “Daunorubicin Precautions” section.

Common side effects of daunorubicin include the following:

• nausea
• vomiting
• sores in the mouth and throat
• diarrhea
• stomach pain
• hair loss
• red urine

This is not a complete list of daunorubicin's side effects. Ask your doctor or pharmacist for more information. Tell your doctor if you have any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Cyclophosphamide (Cytoxan, Neosar)
• Myelosuppressive agents (medications that can decrease the production of cells responsible for the immune system) 
• Hepatotoxic drugs (medications that can harm the liver)
• Have previously received doses of doxorubicin

This is not a complete list of daunorubicin's drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with daunorubicin including the following: 

• hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:
  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing or swallowing
  • rash
  • hives (swollen, red bumps that appear suddenly on the skin)
• injection site reaction. Tell your healthcare provider if you experience any redness, pain, swelling, or burning at the site where the injection was given.
• hyperuricemia. Your healthcare provider will monitor your uric acid levels. You healthcare provider may administer allopurinol, a medication used to control uric acid levels. Tell your doctor if you experience joint pain, stiffness, or swelling
• heart toxicity. Toxicity from daunorubicin may occur, which may result in disease of the heart muscle or heart failure.

Daunorubicin requires close patient observation and frequent blood lab work. Heart, kidney, and liver function should be evaluated prior to each course of treatment. 

Do not take daunorubicin if you are allergic to daunorubicin or to any of its ingredients.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of daunorubicin, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking daunorubicin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to daunorubicin or to any of its ingredients
• have kidney problems
• have liver problems
• have heart problems. This can increase the risk of cardiac toxicity. Your healthcare provider should weigh the benefits and risks with you before using this drug.
• have pre-existing bone marrow suppression. Your healthcare provider should weigh the benefits and risks with you before using this drug.
• have previously used this drug. Previous use of this drug can increase the risk of cardiac toxicity. Your healthcare provider should weigh the benefits and risks with you before using this drug.
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Daunorubicin falls into category D. It has been shown that use of daunorubicin in pregnant women caused some babies to be born with problems. However, in some serious situations, the benefit of using this medication may be greater than the risk of harm to the baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if daunorubicin crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, mothers should be advised to discontinue nursing during daunorubicin therapy.

Take daunorubicin exactly as prescribed. This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional. If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of daunorubicin at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have or results from blood work
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age

The daunorubicin dose you receive is based on your height and weight which is used to calculate your body surface area. It is usually injected on days 1, 2, and 3 of the first course and days 1 and 2 of subsequent courses.  Follow your doctor's instructions about your individual dosing schedule. It is important to keep all of your appointments to receive your daunorubicin dose.

If you take too much daunorubicin, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away. If daunorubicin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

1. Daunorubicin injection must be given into a rapidly flowing intravenous infusion. It must never be given by the intramuscular or subcutaneous route. Severe local tissue necrosis will occur if there is extravasation during administration.
2. Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy. The incidence of myocardial toxicity increases after a total cumulative dose exceeding 400 to 550 mg/m2 in adults, 300 mg/m2 in children more than 2 years of age, or 10 mg/kg in children less than 2 years of age.
3. Severe myelosuppression occurs when used in therapeutic doses; this may lead to infection or hemorrhage.
4. It is recommended that daunorubicin be administered only by physicians who are experienced in leukemia chemotherapy and in facilities with laboratory and supportive resources adequate to monitor drug tolerance and protect and maintain a patient compromised by drug toxicity. The physician and institution must be capable of responding rapidly and completely to severe hemorrhagic conditions and/or overwhelming infection.
5. Dosage should be reduced in patients with impaired hepatic or renal function.