Daunorubicin

Daunorubicin is a prescription medicine used to treat the symptoms of acute nonlymphocytic and lymphocytic leukemia.

• Daunorubicin is available under the following different brand names: Cerubidine

Adult and pediatric dosage

Injectable solution

• 5mg/mL

Powder for injection

• 20mg

Acute Nonlymphocytic Leukemia

Adult dosage

• In combination with cytarabine 100 mg/m²/day IV for 7 days the first course, for 5 days subsequent courses 
• Adults below 60 years: 45 mg/m² IVP days 1, 2, 3 first course; days 1, 2 subsequent courses
• Adults above 60 years: 30 mg/m² IVP days 1, 2, 3 first course; days 1, 2 subsequent courses

Pediatric dosage

• Children below 2 years or less than 0.5 m² body surface area: 1 mg/kg IVP every Week 
• Children above 2 years or more than 0.5 m² body surface area: 25 mg/m² IVP every Week

Acute Lymphocytic Leukemia

Adult dosage

• 45 mg/m² IVP days 1, 2, 3 

Pediatric dosage

• Children below 2 years or less than 0.5 m² body surface area: 1 mg/kg IVP every Week 
• Children above 2 years or more than 0.5 m² body surface area: 25 mg/m² IVP every Week
  • Limitations of Use
    • Limit lifetime dose to less than 550 mg/m² (including doses of related drugs) to reduce risk of cardiotoxicity (400 mg/m² for patients who received irradiation of cardiac region)
    • Limit lifetime dose for children 2 years old or older to 300 mg/sq.meter, and for children below 2 years old to 10 mg/kg to avoid irreversible cardiotoxicity

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Daunorubicin include:

• mild nausea,
• vomiting,
• diarrhea,
• stomach pain,
• temporary hair loss,
• mild itching,
• rash, and
• red-colored urine for 1 or 2 days following a dose.

Serious side effects of Daunorubicin include:

• hives,
• difficulty breathing,
• swelling of face, lips, tongue, or throat,
• chest pain,
• shortness of breath,
• swelling,
• rapid weight gain,
• fever,
• chills,
• body aches,
• flu symptoms,
• sores in the mouth and throat,
• easy bruising,
• unusual bleeding (nose, mouth, vagina, or rectum),
• nausea,
• upper stomach pain,
• itching,
• loss of appetite,
• dark urine,
• clay-colored stools,
• yellowing of the skin or eyes (jaundice), and
• pain, burning, irritation, or skin changes where the injection was given.

Rare side effects of Daunorubicin include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Daunorubicin has severe interactions with no other drugs.
• Daunorubicin has serious interactions with the following drugs:
  • adenovirus types 4 and 7 live, oral
  • darolutamide
  • eliglustat
  • erdafitinib
  • influenza virus vaccine quadrivalent, adjuvanted
  • influenza virus vaccine trivalent, adjuvanted
  • lasmiditan
  • palifermin
  • ropeginterferon alfa 2b
  • sotorasib
  • tepotinib
  • tofacitinib
  • trastuzumab
  • trastuzumab deruxtecan
• Daunorubicin has moderate interactions with at least 65 other drugs.
• Daunorubicin has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity
• Active infection
• IM or SC administration (vesicant)
• Patients who have received max cumulative dose of daunorubicin or doxorubicin
• Patients with preexisting myelosuppression from other drug treatments

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Daunorubicin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Daunorubicin?”

Cautions

• Risk of severe cardiotoxicity (including CHF) & myelosuppression
• Caution in hepatic/renal impairment
• Children may be more sensitive to cardiotoxic effects than adults
• Avoid pregnancy
• Secondary leukemias reported when used in combination with radiation or chemotherapy

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk.
• Lactation
  • Excretion in milk unknown/not recommended