DAUNOrubicin and Cytarabine
Class: Antineoplastic Agents
Chemical Name: 4-amino-1-[(2R,3S,4S,5R)-3,4-dihydroxy-5-(hydroxymethyl)oxolan-2-yl]pyrimidin-2-one
Molecular Formula: C9H13N3O5C27H29NO10
CAS Number: 147-94-4
Warning
Lack of Interchangeability with Other Daunorubicin and Cytarabine Preparations
The commercially available fixed liposomal combination of daunorubicin and cytarabine (daunorubicin/cytarabine liposomal; Vyxeos) is not interchangeable with other daunorubicin and/or cytarabine preparations. (See Lack of Interchangeability with Other Daunorubicin and Cytarabine Preparations under Cautions.)
Properties of these formulations differ, and dosage for each product is specific to the formulation.
Confirm correct drug and dose prior to preparation and administration.
Introduction
Antineoplastic; fixed combination of daunorubicin (an anthracycline) and cytarabine (an antimetabolite) coencapsulated in liposomes.
Uses for DAUNOrubicin and Cytarabine
Acute Myeloid Leukemia (AML)
Treatment of newly diagnosed therapy-related AML (t-AML; secondary AML) or AML with myelodysplasia-related changes (AML-MRC) in adults (designated an orphan drug by FDA for this use).
May be used for remission induction as well as consolidation therapy.
Evidence supporting efficacy is based principally on a study performed in patients with high-risk AML (i.e., patients >60 years of age with t-AML or AML-MRC).
DAUNOrubicin and Cytarabine Dosage and Administration
General
Not interchangeable with other daunorubicin and/or cytarabine preparations. Confirm correct drug name, formulation, and dose prior to preparation and administration. (See Boxed Warning.)
Monitor cardiac, hepatic, and renal function prior to initiation of induction therapy and prior to each cycle of consolidation therapy. Also monitor CBCs prior to each cycle of consolidation therapy; consolidation therapy should be withheld until neutrophil counts >500/mm3 and platelet counts >50,000/mm3.
Calculate lifetime cumulative anthracycline exposure prior to each cycle of daunorubicin/cytarabine liposomal. (See Cardiac Effects under Cautions.)
Premedicate with an antiemetic agent.
Consult specialized references for procedures for proper handling and disposal of antineoplastics.
Administration
IV Administration
For solution compatibility information, see Compatibility under Stability.
Administer only by IV infusion through a central venous line (e.g., central venous catheter or peripherally inserted central catheter [PICC]) using an infusion pump; do not use an inline filter. Daunorubicin component may cause severe tissue necrosis if extravasation occurs; do not administer IM or sub-Q.
Following administration, flush IV line with 0...
