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.
Reduce dose by 20-30%.
Reduce dose by 20-30%.
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.
Incompatible with Na chloride 0.9%, chloride containing solution.
Pre-existing drug-induced or radiation therapy-induced bone marrow suppression. Pregnancy and lactation. Concomitant administration with live vaccines.
Renal and hepatic impairment.
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.
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.
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.
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.
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.
L01XX01 - amsacrine ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.
Amsidine 75 mg/1.5 mL Concentrate and Solvent for Concentrate for Solution for Infusion (Eurocept International BV)
. MHRA. https://products.mhra.gov.uk/. Accessed 07/07/2020.Anon. Amsacrine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/07/2020.Buckingham R (ed). Amsacrine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/07/2020.Joint Formulary Committee. Amsacrine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/07/2020.