Amsacrine


Concise Prescribing Info
Indications/Uses
Acute leukaemia.
Dosage/Direction for Use
Adult : IV Induction of remission: 90 mg/m2 daily for 5-8 days. Courses may be repeated at 2- to 4-week intervals according to response, and may be increased to 120 mg/m2 daily in subsequent courses if tolerated. Maintenance: 150 mg/m2 as a single dose or divided over 3 consecutive days. Doses are given every 3-4 weeks, adjusted as necessary according to response. All doses are given via infusion over 60-90 minutes.
Dosage Details
Intravenous
Acute Leukaemia
Adult: Induction of remission: 90 mg/m2 daily for 5-8 days. Courses may be repeated at 2- to 4-week intervals according to response, and may be increased to 120 mg/m2 daily in subsequent courses if tolerated. Maintenance: 150 mg/m2 as a single dose or divided over 3 consecutive days. Doses are given every 3-4 weeks, adjusted as necessary according to response. All doses are given via infusion over 60-90 minutes.
Renal Impairment
Reduce dose by 20-30%.
Hepatic Impairment
Reduce dose by 20-30%.
Reconstitution
Add 1.5 mL of amsacrine to 13.5 mL of diluent providing a solution containing in a 5 mg/mL; further dilute with 500 mL of 5% glucose inj.
Incompatibility
Incompatible with Na chloride 0.9%, chloride containing solution.
Contraindications
Pre-existing drug-induced or radiation therapy-induced bone marrow suppression. Pregnancy and lactation. Concomitant administration with live vaccines.
Special Precautions
Renal and hepatic impairment.
Adverse Reactions
Significant: Bone marrow suppression, cardiovascular effects (e.g. acute arrhythmia, heart failure, bradycardia, tachycardia), extravasation, tumour lysis syndrome.
Blood and lymphatic system disorders: Thrombocytopenia, pancytopenia.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain.
General disorders and administration site conditions: Pyrexia, infusion site phlebitis; injection site irritation, necrosis, skin inflammation.
Hepatobiliary disorders: Hepatitis, jaundice, hepatic insufficiency.
Investigations: Increased hepatic enzymes.
Metabolism and nutrition disorders: Hypokalaemia.
Nervous system disorders: Grand mal seizure, headache, hypoesthesia, dizziness, peripheral neuropathy
Psychiatric disorders: Affect lability.
Renal and urinary disorders: Hematuria.
Respiratory, thoracic and mediastinal disorders: Dyspnoea.
Skin and subcutaneous tissue disorders: Purpura, alopecia, urticaria, rash.
Vascular disorders: Hypotension.
Potentially Fatal: Infection, haemorrhage, stomatitis.
MonitoringParameters
Monitor LFT, kidney function prior to and during treatment. Monitor CBC with differential frequently during induction and for 2-3 weeks after, electrolytes prior to each dose, bone marrow studies periodically; ECG during and after administration. Monitor for signs and symptoms of infection, tumour lysis syndrome, bleeding, and fluid status during therapy. Monitor infusion site during infusion.
Overdosage
Symptoms: Haemorrhage, infection, severe mucositis, vomiting or diarrhoea. Management: symptomatic and supportive treatment. Bone marrow hypoplasia or aplasia may require treatment with red cell, granulocyte or platelet transfusions and appropriate antibiotics.
Drug Interactions
May increase risk of cardiotoxicity with diuretics or nephrotoxic drugs (e.g. aminoglycosides). May diminish therapeutic effects of vaccines. May potentiate adverse effects with other cytotoxic agents.
Action
Description: Amsacrine, an antineoplastic agent, intercalates with DNA and inhibits nucleic acid synthesis, causing breakage of double-strand DNA and cell cycle arrest at the G2 or S phase.
Pharmacokinetics:
Distribution: Plasma protein binding: Approx 98%.
Metabolism: Metabolised in the liver.
Excretion: Mainly via bile as metabolites; urine (35%; 20% as unchanged drug). Elimination half-life: 5-8 hours.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store below 25°C. Protect from light.
ATC Classification
L01XX01 - amsacrine ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.
Disclaimer: This information is independently developed by MIMS based on Amsacrine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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