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ACUTE EXPOSURE INFORMATION

  1. WITH THERAPEUTIC USE
    1. The dose-limiting toxicity of dactinomycin is bone marrow suppression. Other adverse effects that may occur following therapeutic administration include nausea and vomiting, stomatitis, mucositis, hepatotoxicity, fatigue, lethargy, alopecia, and dermatitis. In general, the majority of symptoms (with the exception of nausea and vomiting) will occur 2 to 4 days after discontinuation of a course of therapy. Nausea and vomiting generally occur within a few hours following administration.
    1. Dactinomycin is extremely corrosive. Extravasation during intravenous administration may result in severe damage to soft tissues.
  1. WITH POISONING/EXPOSURE
    1. Dactinomycin overdose information is limited. A 10-fold overdose (0.15 mg/kg/day for 3 days instead of the prescribed 0.015 mg/kg/day) in an 18-month-old child resulted in hypotension, pancytopenia, acute renal failure, pancreatitis, and severe mucositis.
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