Dactinomycin – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 58 min read

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Article Summary

Dactinomycin is an intravenously administered, antineoplastic antibiotic that is used in the treatment of solid tumors in children and choriocarcinoma in adult women. In high doses, dactinomycin can cause severe liver injury including sinusoidal obstruction syndrome. Dactinomycin is a chromopeptide antineoplastic antibiotic isolated from the bacterium Streptomyces parvulus. Dactinomycin intercalates between adjacent guanine-cytosine base pairs, blocking the transcription of DNA by RNA polymerase; it also causes single-strand...

Key Takeaways

This article explains Mechanism of Action in simple medical language.
This article explains Indications in simple medical language.
This article explains Contraindications in simple medical language.
This article explains Dosage in simple medical language.

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Written byDr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

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Definition

Dactinomycin is an intravenously administered, antineoplastic antibiotic that is used in the treatment of solid tumors in children and choriocarcinoma in adult women. In high doses, dactinomycin can cause severe liver injury including sinusoidal obstruction syndrome.

Dactinomycin is a chromopeptide antineoplastic antibiotic isolated from the bacterium Streptomyces parvulus. Dactinomycin intercalates between adjacent guanine–cytosine base pairs, blocking the transcription of DNA by RNA polymerase; it also causes single-strand DNA breaks, possibly via a free-radical intermediate or an interaction with topoisomerase II. (NCI04)

Mechanism of Action

Good evidence exists that this drug bind strongly, but reversibly, to DNA, interfering with the synthesis of RNA (prevention of RNA polymerase elongation) and, consequently, with protein synthesis.

The capacity of actinomycins to bind with double-helical DNA is responsible for their biological activity and cytotoxicity. X-ray studies of a crystalline complex between dactinomycin and deoxyguanosine permitted the formulation of a model that appears to explain the binding of the drug to DNA. The planar phenazone ring intercalates between adjacent guanine–cytosine base pairs of DNA, while the polypeptide chains extend along the minor groove of the helix. The summation of these interactions provides great stability to the dactinomycin-DNA complex, and as a result of the binding of dactinomycin, the transcription of DNA by RNA polymerase is blocked. DNA-dependent RNA polymerases are much more sensitive to the effects of dactinomycin than DNA polymerases. In addition, dactinomycin causes single-strand breaks in DNA, possibly through a free-radical intermediate or as a result of the action of topoisomerase II

Dactinomycin is an antineoplastic antibiotic. The drug has bacteriostatic activity, particularly against gram-positive organisms, but its cytotoxicity precludes its use as an anti-infective agent. Although the exact mechanism(s) of action has not been fully elucidated, the drug appears to inhibit DNA-dependent RNA synthesis by forming a complex with DNA by intercalating with guanine residues and impairing the template activity of DNA. Protein and DNA synthesis are also inhibited but less extensively and at higher concentrations of dactinomycin than are needed to inhibit RNA synthesis. Dactinomycin is immunosuppressive and also possesses some hypocalcemic activity similar to plicamycin.

In cell biology, actinomycin D is shown to have the ability to inhibit transcription. Actinomycin D does this by binding DNA at the transcription initiation complex and preventing elongation of the RNA chain by RNA polymerase.

Indications

Antineoplastic; Anti-Bacterial Agents; Nucleic Acid Synthesis Inhibitors; Protein Synthesis Inhibitors
For the treatment of Wilms’ tumor, childhood rhabdomyosarcoma, Ewing’s sarcoma, and metastatic, nonseminomatous testicular cancer as part of a combination chemotherapy and/or multi-modality treatment regimen
Dactinomycin is an intravenously administered, antineoplastic antibiotic that is used in the treatment of solid tumors in children and choriocarcinoma in adult women. In high doses, dactinomycin can cause severe liver injury including sinusoidal obstruction syndrome.
Dactinomycin, as part of a combination chemotherapy and/or multi-modality treatment regimen, is indicated for the treatment of Wilms’ tumor, childhood rhabdomyosarcoma, Ewing’s sarcoma and metastatic, nonseminomatous testicular cancer.
Dactinomycin is indicated as a single agent, or as part of a combination chemotherapy regimen, for the treatment of gestational trophoblastic neoplasia.
Dactinomycin, as a component of regional perfusion, is indicated for the palliative and/or adjunctive treatment of locally recurrent or locoregional solid malignancies.
Ewing’s Sarcoma
Gestational Trophoblastic Disease
Ovarian Cancer
Rhabdomyosarcomas
Sarcoma, Osteogenic
Wilms’ tumor
Metastatic nonseminomatous Testicular cancer

Use in Cancer

Dactinomycin is approved to be used alone or with other drugs to treat:

Ewing sarcoma in adults and children.
Gestational trophoblastic disease in adults and children.
Rhabdomyosarcoma in adults and children.
Solid tumors that are locally recurrent. It is used as palliative and/or adjuvant therapy in adults.
Testicular cancer. It is used in adults and children whose nonseminomas have metastasized (spread to other parts of the body).
Wilms tumor in adults and children.

Dactinomycin is also being studied in the treatment of other types of cancer.

Contraindications

shingles
a bad infection
low blood counts due to bone marrow failure
anemia
decreased blood platelets
low levels of white blood cells
low levels of a type of white blood cell called neutrophils
a blood clot in a vein of the liver
liver problems
ascites
abnormal liver function tests
pregnancy
a patient who is producing milk and breastfeeding
infection caused by the varicella zoster virus
exposure to the chickenpox

Dosage

Strengths: 0.5 mg

Wilms’ Tumor

As part of a multi-agent combination chemotherapy regimen: 45 mcg/kg IV over 10 to 15 minutes once every 3 to 6 weeks for up to 26 weeks
For the treatment of Wilms tumor as part of a multi-phase combination chemotherapy regimen

Rhabdomyosarcoma

As part of a multi-agent combination chemotherapy regimen: 15 mcg/kg IV over 10 to 15 minutes once daily for 5 days every 3 to 9 weeks for up to 112 weeks
For the treatment of rhabdomyosarcoma as part of a multi-phase combination chemotherapy regimen

Ewing’s Sarcoma

As part of a multi-agent combination chemotherapy regimen: 1250 mcg/m2 IV over 10 to 15 minutes once every 3 weeks for 51 weeks
For the treatment of Ewing sarcoma as part of a multi-phase combination chemotherapy regimen

Testicular Cancer

As part of a cisplatin-based multi-agent combination chemotherapy regimen: 1000 mcg/m2 IV over 10 to 15 minutes once every 3 weeks for 12 weeks
For the treatment of metastatic non-seminomatous testicular cancer as part of a multi-phase combination chemotherapy regimen

Trophoblastic Disease

As a single agent for nonmetastatic and low-risk metastatic disease: 12 mcg/kg IV over 10 to 15 minutes daily for 5 days
As part of a multi-agent combination chemotherapy regimen for high-risk metastatic disease: 500 mcg IV over 10 to 15 minutes Days 1 and 2 every 2 weeks for up to 8 weeks
For the treatment of post-menarchal patients with gestational trophoblastic neoplasia as a single agent or as part of a combination chemotherapy regimen

Solid Tumors

In combination with melphalan for the lower extremity or pelvis: 50 mcg/kg IV over 10 to 15 minutes once
In combination with melphalan for the upper extremity: 35 mcg/kg IV once
For the treatment of adult patients with locally recurrent or locoregional solid malignancies as a component of palliative or adjunctive regional perfusion

Pediatric Dose

Wilms’ Tumor

As part of a multi-agent combination chemotherapy regimen: 45 mcg/kg IV over 10 to 15 minutes once every 3 to 6 weeks for up to 26 weeks
For the treatment of Wilms tumor as part of a multi-phase combination chemotherapy regimen

Rhabdomyosarcoma

As part of a multi-agent combination chemotherapy regimen: 15 mcg/kg IV over 10 to 15 minutes once daily for 5 days every 3 to 9 weeks for up to 112 weeks
For the treatment of rhabdomyosarcoma as part of a multi-phase combination chemotherapy regimen

Ewing’s Sarcoma

As part of a multi-agent combination chemotherapy regimen: 1250 mcg/m2 IV over 10 to 15 minutes once every 3 weeks for 51 weeks
For the treatment of Ewing sarcoma as part of a multi-phase combination chemotherapy regimen

Testicular Cancer

As part of a cisplatin-based multi-agent combination chemotherapy regimen: 1000 mcg/m2 IV over 10 to 15 minutes once every 3 weeks for 12 weeks
For the treatment of metastatic non-seminomatous testicular cancer as part of a multi-phase combination chemotherapy regimen

Trophoblastic Disease

As a single agent for nonmetastatic and low-risk metastatic disease: 12 mcg/kg IV over 10 to 15 minutes daily for 5 days
As part of a multi-agent combination chemotherapy regimen for high-risk metastatic disease: 500 mcg IV over 10 to 15 minutes Days 1 and 2 every 2 weeks for up to 8 weeks
For the treatment of post-menarchal pediatric patients with gestational trophoblastic neoplasia as a single agent or as part of a combination chemotherapy regimen

Administration advice:

Administer the diluted reconstituted product IV over 10 to 15 minutes.
Do not use in-line filters with a cellulose ester membrane.

Side Effects

The Most Common

Common adverse drug reaction includes bone marrow suppression, fatigue, hair loss, mouth ulcer, loss of appetite and diarrhea. Actinomycin is a vesicant if extravasation occurs.
vomiting
stomach pain
diarrhea
hair loss
hives
rash
difficulty breathing or swallowing
nausea
extreme tiredness
unusual bleeding or bruising
sores in the mouth and throat
lack of energy
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
fever, sore throat, ongoing cough and congestion, or other signs of infection
unusual bleeding or bruising
black and tarry stools
red blood in stools

More Common

sores in the mouth and throat
fever, sore throat, chills, or other signs of infection
black and tarry stools
red blood in stools
nausea
extreme tiredness
unusual bleeding or bruising
lack of energy
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
flu-like symptoms
decreased urination
swelling of the face, arms, hands, feet, ankles, or lower legs
blisters or rash
swelling or tenderness in your stomach (upper right side), rapid weight gain;
swelling in your arms or legs;
dark urine, jaundice (yellowing of the skin or eyes);
redness of your skin or the inside of your mouth and throat (if you are also receiving radiation treatment);
sores or white patches in or around your mouth, trouble swallowing or talking, dry mouth, bad breath, altered sense of taste;
blisters, ulcers, or other skin changes where an injection was given; or
low blood cell counts–fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath.

Rare

constipation
fatigue
nausea and vomiting
skin darkening or redness of areas where radiation was given
skin rash or acne
temporary loss of hair
diarrhea
difficulty swallowing
pain, redness, or swelling at the place of injection
signs of infection such as fever higher than 38°C (100°F), chills, sweating, sore throat, coughing, painful urination, unusual vaginal itching or discharge, or redness or swelling around a cut, wound, or catheter site
sores in mouth
stomach pain
symptoms of anemia such as fatigue, weakness, or shortness of breath
symptoms of liver problems such as yellow eyes or skin, swelling or enlargement of the abdomen, dark urine, pale stools, nausea, or vomiting
unusual bleeding (e.g., black or tarry stools or blood in the urine) or bruising
weight loss
symptoms of a severe allergic reaction such as hives, difficulty breathing, or swelling of the mouth or throat
symptoms of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)

Drug interactions

DRUG	INTERACTION
Abatacept	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Abatacept.
Abciximab	The risk or severity of bleeding can be increased when Abciximab is combined with Dactinomycin.
Abemaciclib	Abemaciclib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Abrocitinib	The serum concentration of Dactinomycin can be increased when it is combined with Abrocitinib.
Acenocoumarol	The risk or severity of bleeding can be increased when Acenocoumarol is combined with Dactinomycin.
Acetylsalicylic acid	The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Dactinomycin.
Adalimumab	The risk or severity of adverse effects can be increased when Adalimumab is combined with Dactinomycin.
Adenovirus	The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Dactinomycin.
Afatinib	The serum concentration of Dactinomycin can be increased when it is combined with Afatinib.
Aldesleukin	The risk or severity of adverse effects can be increased when Aldesleukin is combined with Dactinomycin.
Alectinib	Alectinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Alefacept	The risk or severity of adverse effects can be increased when Alefacept is combined with Dactinomycin.
Alemtuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dactinomycin.
Allogeneic	The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Dactinomycin.
Allopurinol	The risk or severity of adverse effects can be increased when Allopurinol is combined with Dactinomycin.
Alteplase	The risk or severity of bleeding can be increased when Alteplase is combined with Dactinomycin.
Altretamine	The risk or severity of adverse effects can be increased when Altretamine is combined with Dactinomycin.
Ambrisentan	The serum concentration of Dactinomycin can be increased when it is combined with Ambrisentan.
Amiodarone	The serum concentration of Dactinomycin can be increased when it is combined with Amiodarone.
Amsacrine	The risk or severity of adverse effects can be increased when Amsacrine is combined with Dactinomycin.
Anagrelide	The risk or severity of bleeding can be increased when Anagrelide is combined with Dactinomycin.
Anakinra	The risk or severity of adverse effects can be increased when Anakinra is combined with Dactinomycin.
Ancrod	The risk or severity of bleeding can be increased when Ancrod is combined with Dactinomycin.
Anifrolumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Anifrolumab.
Anistreplase	The risk or severity of bleeding can be increased when Anistreplase is combined with Dactinomycin.
Anthrax immune	The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Dactinomycin.
Anthrax vaccine	The risk or severity of infection can be increased when Anthrax vaccine is combined with Dactinomycin.
Antilymphocyte	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Antilymphocyte immunoglobulin (horse).
Antithrombin Alfa	The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Dactinomycin.
Antithrombin III human	The risk or severity of bleeding can be increased when Antithrombin III human is combined with Dactinomycin.
Antithymocyte	The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Dactinomycin.
Apalutamide	The serum concentration of Dactinomycin can be decreased when it is combined with Apalutamide.
Apixaban	The serum concentration of Dactinomycin can be increased when it is combined with Apixaban.
Apremilast	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Apremilast.
Ardeparin	The risk or severity of bleeding can be increased when Ardeparin is combined with Dactinomycin.
Argatroban	The risk or severity of bleeding can be increased when Argatroban is combined with Dactinomycin.
Arsenic trioxide	The serum concentration of Dactinomycin can be increased when it is combined with Arsenic trioxide.
Articaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Articaine.
Asciminib	The serum concentration of Dactinomycin can be increased when it is combined with Asciminib.
COVID-19 Vaccine	The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Dactinomycin.
Asunaprevir	The serum concentration of Dactinomycin can be increased when it is combined with Asunaprevir.
Avanafil	Avanafil may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Avatrombopag	Avatrombopag may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Axitinib	The serum concentration of Axitinib can be increased when it is combined with Dactinomycin.
Azacitidine	The risk or severity of adverse effects can be increased when Azacitidine is combined with Dactinomycin.
Azathioprine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Azathioprine.
live antigen	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Dactinomycin.
calmette-guerin	The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Dactinomycin.
Bacillus	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Dactinomycin.
Baricitinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Baricitinib.
Basiliximab	The risk or severity of adverse effects can be increased when Basiliximab is combined with Dactinomycin.
BCG vaccine	The risk or severity of infection can be increased when BCG vaccine is combined with Dactinomycin.
Beclomethasone	The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Dactinomycin.
Belantamab	The serum concentration of Dactinomycin can be increased when it is combined with Belantamab mafodotin.
Belatacept	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Belatacept.
Belimumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Belimumab.
Belinostat	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Belinostat.
Belumosudil	The serum concentration of Dactinomycin can be increased when it is combined with Belumosudil.
Bemiparin	The risk or severity of bleeding can be increased when Bemiparin is combined with Dactinomycin.
Bendamustine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Bendamustine.
Bendroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Dactinomycin.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Benzocaine.
Benzthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Dactinomycin.
Benzyl alcohol	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Benzyl alcohol.
Berotralstat	The serum concentration of Dactinomycin can be increased when it is combined with Berotralstat.
Betamethasone	The risk or severity of adverse effects can be increased when Betamethasone is combined with Dactinomycin.
Betrixaban	The serum concentration of Dactinomycin can be increased when it is combined with Betrixaban.
Bexarotene	The risk or severity of adverse effects can be increased when Bexarotene is combined with Dactinomycin.
Bimekizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Bimekizumab.
Binimetinib	The serum concentration of Binimetinib can be increased when it is combined with Dactinomycin.
Bisoprolol	The serum concentration of Dactinomycin can be increased when it is combined with Bisoprolol.
Bivalirudin	The risk or severity of bleeding can be increased when Bivalirudin is combined with Dactinomycin.
Bleomycin	The risk or severity of adverse effects can be increased when Bleomycin is combined with Dactinomycin.
Blinatumomab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Blinatumomab.
Bordetella	The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Dactinomycin.
Bortezomib	The risk or severity of adverse effects can be increased when Bortezomib is combined with Dactinomycin.
Bosutinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Bosutinib.
Brentuximab vedotin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Brentuximab vedotin.
Brigatinib	Brigatinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Brodalumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Brodalumab.
Budesonide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Budesonide.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Bupivacaine.
Buprenorphine	Buprenorphine may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Busulfan	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Busulfan.
Butacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Butacaine.
Butamben	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Butamben.
Cabazitaxel	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Cabazitaxel.
Cabergoline	The serum concentration of Cabergoline can be increased when it is combined with Dactinomycin.
Caffeine	Caffeine may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Canagliflozin	The serum concentration of Dactinomycin can be increased when it is combined with Canagliflozin.
Canakinumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Canakinumab.
Cangrelor	The risk or severity of bleeding can be increased when Cangrelor is combined with Dactinomycin.
Cannabidiol	Cannabidiol may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Capecitabine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Capecitabine.
Caplacizumab	The risk or severity of bleeding can be increased when Caplacizumab is combined with Dactinomycin.
Capmatinib	The serum concentration of Dactinomycin can be increased when it is combined with Capmatinib.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Capsaicin.
Carbamazepine	The risk or severity of adverse effects can be increased when Carbamazepine is combined with Dactinomycin.
Carboplatin	The risk or severity of adverse effects can be increased when Carboplatin is combined with Dactinomycin.
Carfilzomib	The serum concentration of Dactinomycin can be increased when it is combined with Carfilzomib.

Carmustine	The risk or severity of adverse effects can be increased when Carmustine is combined with Dactinomycin.
Carvedilol	The serum concentration of Dactinomycin can be increased when it is combined with Carvedilol.
Ceritinib	The serum concentration of Ceritinib can be increased when it is combined with Dactinomycin.
Certolizumab pegol	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Certolizumab pegol.
Chlorambucil	The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dactinomycin.
Chloramphenicol	The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Dactinomycin.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Chloroprocaine.
Chlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Dactinomycin.
Cholesterol	Cholesterol may increase the excretion rate of Dactinomycin which could result in a lower serum level and potentially a reduction in efficacy.
Ciclesonide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ciclesonide.
Cilostazol	The risk or severity of bleeding can be increased when Cilostazol is combined with Dactinomycin.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Cinchocaine.
Cisplatin	The risk or severity of adverse effects can be increased when Cisplatin is combined with Dactinomycin.
Cladribine	The risk or severity of adverse effects can be increased when Cladribine is combined with Dactinomycin.
Clarithromycin	The serum concentration of Dactinomycin can be increased when it is combined with Clarithromycin.
Clobazam	The serum concentration of Dactinomycin can be increased when it is combined with Clobazam.
Clobetasol propionate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Clobetasol propionate.
Clofarabine	The risk or severity of adverse effects can be increased when Clofarabine is combined with Dactinomycin.
Clofazimine	The serum concentration of Dactinomycin can be increased when it is combined with Clofazimine.
Clomifene	The serum concentration of Dactinomycin can be increased when it is combined with Clomifene.
Clopidogrel	The risk or severity of bleeding can be increased when Clopidogrel is combined with Dactinomycin.
Clostridium tetani	The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Dactinomycin.
Clozapine	The risk or severity of neutropenia can be increased when Dactinomycin is combined with Clozapine.
Cobicistat	The serum concentration of Dactinomycin can be increased when it is combined with Cobicistat.
Cobimetinib	The serum concentration of Cobimetinib can be increased when it is combined with Dactinomycin.
Cocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Cocaine.
Colchicine	The serum concentration of Dactinomycin can be increased when it is combined with Colchicine.
Conivaptan	The serum concentration of Dactinomycin can be increased when it is combined with Conivaptan.
Copanlisib	The serum concentration of Copanlisib can be increased when it is combined with Dactinomycin.
Corticotropin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Corticotropin.
Cortisone acetate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Cortisone acetate.
Corynebacterium	The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Dactinomycin.
Crizotinib	The serum concentration of Dactinomycin can be increased when it is combined with Crizotinib.
Curcumin	The serum concentration of Dactinomycin can be increased when it is combined with Curcumin.
Cyanocobalamin	The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Dactinomycin.
Cyclopenthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Dactinomycin.
Cyclophosphamide	The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Dactinomycin.
Cyclosporine	Dactinomycin may increase the immunosuppressive activities of Cyclosporine.
Cyclothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Dactinomycin.
Cytarabine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Cytarabine.
Dabigatran	The risk or severity of bleeding can be increased when Dabigatran is combined with Dactinomycin.
Dabigatran etexilate	The serum concentration of Dactinomycin can be increased when it is combined with Dabigatran etexilate.
Dabrafenib	Dabrafenib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Dacarbazine	The risk or severity of adverse effects can be increased when Dacarbazine is combined with Dactinomycin.
Daclatasvir	The serum concentration of Dactinomycin can be increased when it is combined with Daclatasvir.
Dacomitinib	The serum concentration of Dactinomycin can be increased when it is combined with Dacomitinib.
Dalteparin	The risk or severity of bleeding can be increased when Dalteparin is combined with Dactinomycin.
Danaparoid	The risk or severity of bleeding can be increased when Danaparoid is combined with Dactinomycin.
Daptomycin	The serum concentration of Dactinomycin can be increased when it is combined with Daptomycin.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Dactinomycin.
Darolutamide	Darolutamide may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Darunavir	The serum concentration of Dactinomycin can be increased when it is combined with Darunavir.
Dasabuvir	Dasabuvir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Dasatinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Dasatinib.
Daunorubicin	The risk or severity of adverse effects can be increased when Daunorubicin is combined with Dactinomycin.
Decitabine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Decitabine.
Defibrotide	The risk or severity of bleeding can be increased when Defibrotide is combined with Dactinomycin.
Deflazacort	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Deflazacort.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Dactinomycin.
Desirudin	The risk or severity of bleeding can be increased when Desirudin is combined with Dactinomycin.
Desoximetasone	The risk or severity of adverse effects can be increased when Desoximetasone is combined with Dactinomycin.
Deucravacitinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Deucravacitinib.
Dexamethasone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Dexamethasone.
Dexamethasone acetate	The serum concentration of Dactinomycin can be decreased when it is combined with Dexamethasone acetate.
Dexrazoxane	The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Dactinomycin.
Dextran	The risk or severity of bleeding can be increased when Dextran is combined with Dactinomycin.
Dicoumarol	The risk or severity of bleeding can be increased when Dicoumarol is combined with Dactinomycin.
Diethylstilbestrol	Diethylstilbestrol may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Difluocortolone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Difluocortolone.
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Dactinomycin.
Digoxin	The serum concentration of Dactinomycin can be increased when it is combined with Digoxin.
Dimethyl fumarate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Dimethyl fumarate.
Dinutuximab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Dinutuximab.
Diosmin	The serum concentration of Dactinomycin can be increased when it is combined with Diosmin.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Diphenhydramine.
Dipyridamole	The risk or severity of bleeding can be increased when Dipyridamole is combined with Dactinomycin.
Diroximel fumarate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Diroximel fumarate.
Docetaxel	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Docetaxel.
Dolutegravir	The serum concentration of Dactinomycin can be increased when it is combined with Dolutegravir.
Doxorubicin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Doxorubicin.
Dronedarone	The serum concentration of Dactinomycin can be increased when it is combined with Dronedarone.
Drotrecogin alfa	The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Dactinomycin.
Duvelisib	The serum concentration of Dactinomycin can be increased when it is combined with Duvelisib.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Dyclonine.
Ebola Zaire vaccine	The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Dactinomycin.
Eculizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Eculizumab.
Edetic acid	The risk or severity of bleeding can be increased when Edetic acid is combined with Dactinomycin.
Edoxaban	The serum concentration of Dactinomycin can be increased when it is combined with Edoxaban.
Efalizumab	The risk or severity of adverse effects can be increased when Efalizumab is combined with Dactinomycin.
Elagolix	The serum concentration of Dactinomycin can be increased when it is combined with Elagolix.
Elbasvir	Elbasvir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Eliglustat	The serum concentration of Dactinomycin can be increased when it is combined with Eliglustat.
Eltrombopag	Eltrombopag may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Emapalumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Emapalumab.
Enasidenib	The serum concentration of Dactinomycin can be increased when it is combined with Enasidenib.
Enfortumab vedotin	The serum concentration of Dactinomycin can be increased when it is combined with Enfortumab vedotin.
Enoxaparin	The risk or severity of bleeding can be increased when Enoxaparin is combined with Dactinomycin.
Entrectinib	The serum concentration of Dactinomycin can be increased when it is combined with Entrectinib.
Epirubicin	The risk or severity of adverse effects can be increased when Epirubicin is combined with Dactinomycin.
Epoprostenol	The risk or severity of bleeding can be increased when Epoprostenol is combined with Dactinomycin.

Erdafitinib	The serum concentration of Dactinomycin can be increased when it is combined with Erdafitinib.
Eribulin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Eribulin.
Erlotinib	Erlotinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Ertugliflozin	The serum concentration of Dactinomycin can be increased when it is combined with Ertugliflozin.
Erythromycin	The serum concentration of Dactinomycin can be increased when it is combined with Erythromycin.
Erythropoietin	The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Dactinomycin.
Estradiol	Estradiol may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estradiol acetate	Estradiol acetate may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estradiol benzoate	Estradiol benzoate may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estradiol cypionate	Estradiol cypionate may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estradiol dienanthate	Estradiol dienanthate may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estradiol valerate	Estradiol valerate may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Estramustine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Estramustine.
Etanercept	The risk or severity of adverse effects can be increased when Etanercept is combined with Dactinomycin.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Ethyl chloride.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Etidocaine.
Etoposide	The risk or severity of adverse effects can be increased when Etoposide is combined with Dactinomycin.
Everolimus	The serum concentration of Dactinomycin can be increased when it is combined with Everolimus.
Famtozinameran	The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Dactinomycin.
Favipiravir	The serum concentration of Dactinomycin can be increased when it is combined with Favipiravir.
Febuxostat	The excretion of Dactinomycin can be decreased when combined with Febuxostat.
Fedratinib	The serum concentration of Dactinomycin can be increased when it is combined with Fedratinib.
Fexofenadine	The serum concentration of Dactinomycin can be increased when it is combined with Fexofenadine.
Filgotinib	The serum concentration of Dactinomycin can be increased when it is combined with Filgotinib.
Fingolimod	Dactinomycin may increase the immunosuppressive activities of Fingolimod.
Flibanserin	The serum concentration of Dactinomycin can be increased when it is combined with Flibanserin.
Floxuridine	The risk or severity of adverse effects can be increased when Floxuridine is combined with Dactinomycin.
Fluconazole	The serum concentration of Dactinomycin can be increased when it is combined with Fluconazole.
Flucytosine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Flucytosine.
Fludarabine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fludarabine.
Fludrocortisone	The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Dactinomycin.
Fluindione	The risk or severity of bleeding can be increased when Fluindione is combined with Dactinomycin.
Flunisolide	The risk or severity of adverse effects can be increased when Flunisolide is combined with Dactinomycin.
Fluocinolone acetonide	The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Dactinomycin.
Fluocinonide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fluocinonide.
Fluocortolone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fluocortolone.
Fluorometholone	The risk or severity of adverse effects can be increased when Fluorometholone is combined with Dactinomycin.
Fluorouracil	The risk or severity of adverse effects can be increased when Fluorouracil is combined with Dactinomycin.
Flupentixol	The risk or severity of myelosuppression can be increased when Flupentixol is combined with Dactinomycin.
Fluprednisolone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fluprednisolone.
Fluticasone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fluticasone.
Fluticasone furoate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Fluticasone furoate.
Fluticasone propionate	The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Dactinomycin.
Fondaparinux	The risk or severity of bleeding can be increased when Fondaparinux is combined with Dactinomycin.
Fostamatinib	Fostamatinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Fostemsavir	Fostemsavir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Fusidic acid	Fusidic acid may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Futibatinib	The serum concentration of Dactinomycin can be increased when it is combined with Futibatinib.
Gallium nitrate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Gallium nitrate.
Gefitinib	Gefitinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Gemcitabine	The risk or severity of adverse effects can be increased when Gemcitabine is combined with Dactinomycin.
Gemtuzumab ozogamicin	The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Dactinomycin.
Gilteritinib	Gilteritinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Glasdegib	The serum concentration of Dactinomycin can be increased when it is combined with Glasdegib.
Glatiramer	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Glatiramer.
Glecaprevir	The serum concentration of Dactinomycin can be increased when it is combined with Glecaprevir.
Golimumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Golimumab.
Grazoprevir	Grazoprevir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Guselkumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Guselkumab.
Haemophilus	The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Dactinomycin.
Heparin	The risk or severity of bleeding can be increased when Heparin is combined with Dactinomycin.
Hepatitis A Vaccine	The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Dactinomycin.
Hepatitis B Vaccine	The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Dactinomycin.
Human adenovirus	The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Dactinomycin.
Hydrochlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Dactinomycin.
Hydrocortisone acetate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydrocortisone acetate.
Hydrocortisone butyrate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydrocortisone butyrate.
Hydrocortisone succinate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydrocortisone succinate.
Hydroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Dactinomycin.
Hydroxychloroquine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydroxychloroquine.
Hydroxyurea	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydroxyurea.
Ibritumomab tiuxetan	The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Dactinomycin.
Ibrutinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ibrutinib.
Icosapent	The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Dactinomycin.
Idarubicin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Idarubicin.
Idelalisib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Idelalisib.
Ifosfamide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ifosfamide.
Iloprost	The risk or severity of bleeding can be increased when Iloprost is combined with Dactinomycin.
Imatinib	The risk or severity of adverse effects can be increased when Imatinib is combined with Dactinomycin.
Imipramine	The serum concentration of Imipramine can be increased when it is combined with Dactinomycin.
Indacaterol	The serum concentration of Dactinomycin can be increased when it is combined with Indacaterol.
Indomethacin	The risk or severity of adverse effects can be increased when Indomethacin is combined with Dactinomycin.
Inebilizumab	The risk or severity of infection can be increased when Dactinomycin is combined with Inebilizumab.
Infliximab	The risk or severity of adverse effects can be increased when Infliximab is combined with Dactinomycin.

Ketoconazole	The serum concentration of Dactinomycin can be increased when it is combined with Ketoconazole.
Lansoprazole	Lansoprazole may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Lapatinib	The serum concentration of Dactinomycin can be increased when it is combined with Lapatinib.
Larotrectinib	The serum concentration of Dactinomycin can be increased when it is combined with Larotrectinib.
Lasmiditan	The serum concentration of Dactinomycin can be increased when it is combined with Lasmiditan.
Ledipasvir	The serum concentration of Dactinomycin can be increased when it is combined with Ledipasvir.
Lefamulin	The serum concentration of Dactinomycin can be increased when it is combined with Lefamulin.
Leflunomide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Leflunomide.
Lemborexant	The serum concentration of Dactinomycin can be increased when it is combined with Lemborexant.
Lenalidomide	The risk or severity of adverse effects can be increased when Lenalidomide is combined with Dactinomycin.
Lenvatinib	The serum concentration of Dactinomycin can be increased when it is combined with Lenvatinib.
Lepirudin	The risk or severity of bleeding can be increased when Lepirudin is combined with Dactinomycin.
Letermovir	Letermovir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Levobupivacaine.
Levoketoconazole	The serum concentration of Dactinomycin can be increased when it is combined with Levoketoconazole.
Levothyroxine	The serum concentration of Dactinomycin can be decreased when it is combined with Levothyroxine.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Lidocaine.
Linagliptin	The serum concentration of Dactinomycin can be increased when it is combined with Linagliptin.
Linezolid	The risk or severity of adverse effects can be increased when Linezolid is combined with Dactinomycin.
Lipegfilgrastim	Dactinomycin may increase the myelosuppressive activities of Lipegfilgrastim.
Lomitapide	The serum concentration of Dactinomycin can be increased when it is combined with Lomitapide.
Lomustine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Lomustine.
Lonafarnib	The serum concentration of Dactinomycin can be increased when it is combined with Lonafarnib.
Loncastuximab tesirine	The serum concentration of Dactinomycin can be increased when it is combined with Loncastuximab tesirine.
Loperamide	The serum concentration of Dactinomycin can be increased when it is combined with Loperamide.
Lopinavir	The serum concentration of Dactinomycin can be increased when it is combined with Lopinavir.
Lorlatinib	The serum concentration of Dactinomycin can be decreased when it is combined with Lorlatinib.
Loxapine	The serum concentration of Dactinomycin can be increased when it is combined with Loxapine.
Lumacaftor	The serum concentration of Dactinomycin can be decreased when it is combined with Lumacaftor.
Lusutrombopag	The serum concentration of Dactinomycin can be increased when it is combined with Lusutrombopag.
Magnesium	The serum concentration of Magnesium can be decreased when it is combined with Dactinomycin.
Mannitol	The serum concentration of Dactinomycin can be increased when it is combined with Mannitol.
Maribavir	The serum concentration of Dactinomycin can be increased when it is combined with Maribavir.
Measles virus	The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Dactinomycin.
Mechlorethamine	The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Dactinomycin.
Mefloquine	The serum concentration of Dactinomycin can be increased when it is combined with Mefloquine.
Meloxicam	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Meloxicam.
Melphalan	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Melphalan.
Meningococcal	The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Dactinomycin.
Mepivacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Mepivacaine.
Mepolizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mepolizumab.
Meprednisone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Meprednisone.
Mercaptopurine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mercaptopurine.
Methimazole	The risk or severity of adverse effects can be increased when Methimazole is combined with Dactinomycin.
Methotrexate	The risk or severity of adverse effects can be increased when Methotrexate is combined with Dactinomycin.
Methoxy polyethylen	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Dactinomycin.
Methylene blue	The serum concentration of Dactinomycin can be increased when it is combined with Methylene blue.
Methylprednisolone	The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Dactinomycin.
Mifepristone	The serum concentration of Dactinomycin can be decreased when it is combined with Mifepristone.
Mirabegron	The serum concentration of Dactinomycin can be increased when it is combined with Mirabegron.
Mitapivat	The serum concentration of Dactinomycin can be increased when it is combined with Mitapivat.
Mitomycin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dactinomycin.
Mitoxantrone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mitoxantrone.
COVID-19 Vaccine	The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Dactinomycin.
Modified vaccinia ankara	The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Dactinomycin.
Mometasone furoate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mometasone furoate.
Monomethyl fumarate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Monomethyl fumarate.
Morphine	The serum concentration of Dactinomycin can be increased when it is combined with Morphine.
Mosunetuzumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mosunetuzumab.
Mumps virus	The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Dactinomycin.
Muromonab	The risk or severity of adverse effects can be increased when Muromonab is combined with Dactinomycin.
Mycophenolate mofetil	The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Dactinomycin.
Mycophenolic acid	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mycophenolic acid.
Nadroparin	The risk or severity of bleeding can be increased when Nadroparin is combined with Dactinomycin.
Natalizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Natalizumab.
Nelarabine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Nelarabine.
Nelfinavir	Nelfinavir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Neratinib	The serum concentration of Dactinomycin can be increased when it is combined with Neratinib.
Netupitant	The serum concentration of Dactinomycin can be increased when it is combined with Netupitant.
Nilotinib	The serum concentration of Dactinomycin can be increased when it is combined with Nilotinib.
Nimesulide	The risk or severity of bleeding can be increased when Nimesulide is combined with Dactinomycin.
Nintedanib	The serum concentration of Dactinomycin can be increased when it is combined with Nintedanib.
Norgestimate	The serum concentration of Dactinomycin can be increased when it is combined with Norgestimate.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Dactinomycin.
Novobiocin	Novobiocin may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Dactinomycin.
Obinutuzumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Dactinomycin.
Ofatumumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ofatumumab.
Olaparib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Olaparib.
Omadacycline	The serum concentration of Dactinomycin can be increased when it is combined with Omadacycline.
Ombitasvir	The serum concentration of Dactinomycin can be increased when it is combined with Ombitasvir.
Omeprazole	Omeprazole may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Osimertinib	Osimertinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.

Oteseconazole	The serum concentration of Dactinomycin can be increased when it is combined with Oteseconazole.
Oxaliplatin	The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Dactinomycin.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Oxybuprocaine.
Ozanimod	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ozanimod.
Paclitaxel	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Paclitaxel.
Pacritinib	The serum concentration of Dactinomycin can be increased when it is combined with Pacritinib.
Palbociclib	The serum concentration of Dactinomycin can be increased when it is combined with Palbociclib.
Palifermin	The therapeutic efficacy of Palifermin can be decreased when used in combination with Dactinomycin.
Paliperidone	The serum concentration of Dactinomycin can be increased when it is combined with Paliperidone.
Panobinostat	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Panobinostat.
Pantoprazole	Pantoprazole may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Paritaprevir	Paritaprevir may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Parnaparin	The risk or severity of bleeding can be increased when Parnaparin is combined with Dactinomycin.
Pazopanib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pazopanib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Dactinomycin.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pegcetacoplan.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Dactinomycin.
Peginterferon	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Dactinomycin.
Peginterferon	The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Dactinomycin.
Peginterferon	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Pemetrexed is combined with Dactinomycin.
Penicillamine	The risk or severity of adverse effects can be increased when Penicillamine is combined with Dactinomycin.
Pentosan	The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Dactinomycin.
Pentostatin	The risk or severity of adverse effects can be increased when Pentostatin is combined with Dactinomycin.
Pentoxifylline	The risk or severity of bleeding can be increased when Pentoxifylline is combined with Dactinomycin.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Dactinomycin.
Phenindione	The risk or severity of bleeding can be increased when Phenindione is combined with Dactinomycin.
Phenol	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Phenol.
Phenprocoumon	The risk or severity of bleeding can be increased when Phenprocoumon is combined with Dactinomycin.
Phenylalanine	The risk or severity of adverse effects can be increased when Phenylalanine is combined with Dactinomycin.
Pibrentasvir	The serum concentration of Dactinomycin can be increased when it is combined with Pibrentasvir.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Dactinomycin.
Pirfenidone	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pirfenidone.
Pitolisant	The serum concentration of Dactinomycin can be increased when it is combined with Pitolisant.
Polythiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Dactinomycin.
Pomalidomide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pomalidomide.
Ponatinib	The serum concentration of Dactinomycin can be increased when it is combined with Ponatinib.
Ponesimod	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ponesimod.
Posaconazole	The serum concentration of Dactinomycin can be increased when it is combined with Posaconazole.
Pralatrexate	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pralatrexate.
Pralsetinib	The serum concentration of Dactinomycin can be increased when it is combined with Pralsetinib.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Pramocaine.
Prasugrel	The risk or severity of bleeding can be increased when Prasugrel is combined with Dactinomycin.
Pravastatin	Pravastatin may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Prednisolone	The risk or severity of adverse effects can be increased when Prednisolone is combined with Dactinomycin.
Prednisolone phosphate	The serum concentration of Dactinomycin can be decreased when it is combined with Prednisolone phosphate.
Prednisone	The risk or severity of adverse effects can be increased when Prednisone is combined with Dactinomycin.
Prilocaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Prilocaine.
Procaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Procaine.
Procarbazine	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Procarbazine.
Progesterone	Progesterone may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Propafenone	The serum concentration of Dactinomycin can be increased when it is combined with Propafenone.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Proparacaine.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Propoxycaine.
Propylthiouracil	The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Dactinomycin.
Protein C	The risk or severity of bleeding can be increased when Protein C is combined with Dactinomycin.
Protein S human	The risk or severity of bleeding can be increased when Protein S human is combined with Dactinomycin.
Quinidine	The serum concentration of Dactinomycin can be increased when it is combined with Quinidine.
Quinine	The serum concentration of Dactinomycin can be increased when it is combined with Quinine.
Rabeprazole	Rabeprazole may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Rabies immune	The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Dactinomycin.
Rabies virus	The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Dactinomycin.
Rabies virus	The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Dactinomycin.
Raltitrexed	The risk or severity of adverse effects can be increased when Raltitrexed is combined with Dactinomycin.
Ranolazine	The serum concentration of Dactinomycin can be increased when it is combined with Ranolazine.
Ravulizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ravulizumab.
Regorafenib	The serum concentration of Dactinomycin can be increased when it is combined with Regorafenib.
Relugolix	The serum concentration of Dactinomycin can be increased when it is combined with Relugolix.
Reserpine	The serum concentration of Dactinomycin can be increased when it is combined with Reserpine.
Reteplase	The risk or severity of bleeding can be increased when Reteplase is combined with Dactinomycin.
Revefenacin	The serum concentration of Dactinomycin can be increased when it is combined with Revefenacin.
Reviparin	The risk or severity of bleeding can be increased when Reviparin is combined with Dactinomycin.
Rifampicin	The serum concentration of Dactinomycin can be decreased when it is combined with Rifampicin.
Rifamycin	The serum concentration of Dactinomycin can be increased when it is combined with Rifamycin.
Rilonacept	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Rilonacept.
Rilpivirine	Rilpivirine may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Rimegepant	The serum concentration of Dactinomycin can be increased when it is combined with Rimegepant.
Riociguat	The serum concentration of Dactinomycin can be increased when it is combined with Riociguat.
Ripretinib	The serum concentration of Dactinomycin can be increased when it is combined with Ripretinib.
Risankizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Risankizumab.
Ritonavir	The serum concentration of Dactinomycin can be increased when it is combined with Ritonavir.
Rituximab	The risk or severity of adverse effects can be increased when Rituximab is combined with Dactinomycin.
Rivaroxaban	The serum concentration of Dactinomycin can be increased when it is combined with Rivaroxaban.
Roflumilast	Roflumilast may increase the immunosuppressive activities of Dactinomycin.
Rolapitant	The serum concentration of Dactinomycin can be increased when it is combined with Rolapitant.
Romidepsin	The serum concentration of Romidepsin can be increased when it is combined with Dactinomycin.
Ropeginterferon	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ropeginterferon alfa-2b.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Ropivacaine.
Rotavirus vaccine	The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Dactinomycin.
Roxadustat	The serum concentration of Dactinomycin can be increased when it is combined with Roxadustat.
Rubella virus	The risk or severity of infection can be increased when Rubella virus vaccine is combined with Dactinomycin.
Rucaparib	Rucaparib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Ruxolitinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ruxolitinib.
Safinamide	Safinamide may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Sapropterin	The serum concentration of Dactinomycin can be increased when it is combined with Sapropterin.
Saquinavir	The serum concentration of Dactinomycin can be increased when it is combined with Saquinavir.
Sarecycline	The serum concentration of Dactinomycin can be increased when it is combined with Sarecycline.
Sarilumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Sarilumab.
Satralizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Satralizumab

Secukinumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Secukinumab.
Selexipag	The serum concentration of Dactinomycin can be increased when it is combined with Selexipag.
Selumetinib	The serum concentration of Dactinomycin can be increased when it is combined with Selumetinib.
Sildenafil	The serum concentration of Dactinomycin can be increased when it is combined with Sildenafil.
Silodosin	The serum concentration of Dactinomycin can be increased when it is combined with Silodosin.
Siltuximab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Siltuximab.
Simeprevir	The serum concentration of Dactinomycin can be increased when it is combined with Simeprevir.
Simvastatin	The serum concentration of Dactinomycin can be increased when it is combined with Simvastatin.
Siponimod	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Siponimod.
Sipuleucel-T	The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Dactinomycin.
Sirolimus	The risk or severity of adverse effects can be increased when Sirolimus is combined with Dactinomycin.
Sitagliptin	The serum concentration of Dactinomycin can be increased when it is combined with Sitagliptin.
Smallpox	The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Dactinomycin.
Sodium citrate	The risk or severity of bleeding can be increased when Sodium citrate is combined with Dactinomycin.
Sofosbuvir	The serum concentration of Dactinomycin can be increased when it is combined with Sofosbuvir.
Sorafenib	The serum concentration of Dactinomycin can be increased when it is combined with Sorafenib.
Sotagliflozin	The serum concentration of Dactinomycin can be increased when it is combined with Sotagliflozin.
Sotorasib	The serum concentration of Dactinomycin can be increased when it is combined with Sotorasib.
Spesolimab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Spesolimab.
St. John’s Wort	The serum concentration of Dactinomycin can be decreased when it is combined with St. John’s Wort.
Stiripentol	The excretion of Dactinomycin can be decreased when combined with Stiripentol.
Streptokinase	The risk or severity of bleeding can be increased when Streptokinase is combined with Dactinomycin.
Streptozocin	The risk or severity of adverse effects can be increased when Streptozocin is combined with Dactinomycin.
Sulfamethoxazole	The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Dactinomycin.
Sulfasalazine	The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Dactinomycin.
Sulfinpyrazone	The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Dactinomycin.
Sulodexide	The risk or severity of bleeding can be increased when Sulodexide is combined with Dactinomycin.
Sunitinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Sunitinib.
Suvorexant	The serum concentration of Dactinomycin can be increased when it is combined with Suvorexant.
Tacrolimus	Tacrolimus may increase the immunosuppressive activities of Dactinomycin.
Tafamidis	The serum concentration of Dactinomycin can be increased when it is combined with Tafamidis.
Talazoparib	The serum concentration of Talazoparib can be increased when it is combined with Dactinomycin.
Tamoxifen	The serum concentration of Dactinomycin can be increased when it is combined with Tamoxifen.
Taurocholic acid	Taurocholic acid may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Tazemetostat	The serum concentration of Dactinomycin can be increased when it is combined with Tazemetostat.
Technetium	The serum concentration of Dactinomycin can be increased when it is combined with Technetium Tc-99m sestamibi.
Tedizolid	The risk or severity of myelosuppression can be increased when Dactinomycin is combined with Tedizolid phosphate.
Tegaserod	The serum concentration of Dactinomycin can be increased when it is combined with Tegaserod.
Telaprevir	The serum concentration of Dactinomycin can be increased when it is combined with Telaprevir.
Telmisartan	Telmisartan may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Temozolomide	The risk or severity of adverse effects can be increased when Temozolomide is combined with Dactinomycin.
Temsirolimus	The serum concentration of Dactinomycin can be increased when it is combined with Temsirolimus.
Tenecteplase	The risk or severity of bleeding can be increased when Tenecteplase is combined with Dactinomycin.
Teniposide	The risk or severity of adverse effects can be increased when Teniposide is combined with Dactinomycin.
Tenofovir disoproxil	The serum concentration of Dactinomycin can be increased when it is combined with Tenofovir disoproxil.
Tepotinib	The serum concentration of Dactinomycin can be increased when it is combined with Tepotinib.
Teprotumumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Teprotumumab.
Teriflunomide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Teriflunomide.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Dactinomycin is combined with Tetracaine.
Tezacaftor	The serum concentration of Dactinomycin can be increased when it is combined with Tezacaftor.
Thalidomide	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Thalidomide.
Thiotepa	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Thiotepa.
Ticagrelor	The serum concentration of Dactinomycin can be increased when it is combined with Ticagrelor.
encephalitis vaccine	The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Dactinomycin.
Ticlopidine	The risk or severity of bleeding can be increased when Ticlopidine is combined with Dactinomycin.
Tinzaparin	The risk or severity of bleeding can be increased when Tinzaparin is combined with Dactinomycin.
Tioguanine	The risk or severity of adverse effects can be increased when Tioguanine is combined with Dactinomycin.
Tipranavir	The serum concentration of Dactinomycin can be decreased when it is combined with Tipranavir.
Tirofiban	The risk or severity of bleeding can be increased when Tirofiban is combined with Dactinomycin.
Tivozanib	Tivozanib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Tixocortol	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Tixocortol.
Tocilizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Tocilizumab.
Tofacitinib	Dactinomycin may increase the immunosuppressive activities of Tofacitinib.
Tolvaptan	The serum concentration of Tolvaptan can be increased when it is combined with Dactinomycin.
Topotecan	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Topotecan.
Toremifene	The serum concentration of Dactinomycin can be increased when it is combined with Toremifene.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Dactinomycin.
Trabectedin	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Trabectedin.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Dactinomycin.
Trastuzumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Trastuzumab emtansine.
Trazodone	The serum concentration of Dactinomycin can be decreased when it is combined with Trazodone.
Tretinoin	The risk or severity of adverse effects can be increased when Tretinoin is combined with Dactinomycin.
Triamcinolone	The risk or severity of adverse effects can be increased when Triamcinolone is combined with Dactinomycin.
Trichlormethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Dactinomycin.
Trifluridine	The risk or severity of adverse effects can be increased when Trifluridine is combined with Dactinomycin.
Triflusal	The risk or severity of bleeding can be increased when Triflusal is combined with Dactinomycin.
Trilaciclib	The serum concentration of Dactinomycin can be increased when it is combined with Trilaciclib.
Trilostane	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Trilostane.
Trimipramine	The serum concentration of Trimipramine can be increased when it is combined with Dactinomycin.
Tucatinib	Tucatinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Typhoid vaccine	The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Dactinomycin.
Typhoid Vaccine	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Dactinomycin.
polysaccharide	The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Dactinomycin.
Ubrogepant	The serum concentration of Dactinomycin can be increased when it is combined with Ubrogepant.
Umbralisib	The serum concentration of Dactinomycin can be increased when it is combined with Umbralisib.
Umeclidinium	The serum concentration of Dactinomycin can be increased when it is combined with Umeclidinium.
Upadacitinib	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Upadacitinib.
Urokinase	The risk or severity of bleeding can be increased when Urokinase is combined with Dactinomycin.
Vandetanib	The serum concentration of Dactinomycin can be increased when it is combined with Vandetanib.
Vardenafil	The serum concentration of Dactinomycin can be increased when it is combined with Vardenafil.
Varicella	The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Dactinomycin.
Varicella zoster	The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Dactinomycin.
Vedolizumab	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Vedolizumab.
Velpatasvir	The serum concentration of Dactinomycin can be increased when it is combined with Velpatasvir.
Vemurafenib	The serum concentration of Dactinomycin can be increased when it is combined with Vemurafenib.
Venetoclax	The serum concentration of Dactinomycin can be increased when it is combined with Venetoclax.
Venlafaxine	Venlafaxine may increase the excretion rate of Dactinomycin which could result in a lower serum level and potentially a reduction in efficacy.
Verapamil	The serum concentration of Dactinomycin can be increased when it is combined with Verapamil.

Vinblastine	The risk or severity of adverse effects can be increased when Vinblastine is combined with Dactinomycin.
Vincristine	The risk or severity of adverse effects can be increased when Vincristine is combined with Dactinomycin.
Vindesine	The risk or severity of adverse effects can be increased when Vindesine is combined with Dactinomycin.
Vinflunine	The serum concentration of Vinflunine can be increased when it is combined with Dactinomycin.
Vinorelbine	The risk or severity of adverse effects can be increased when Vinorelbine is combined with Dactinomycin.
Vismodegib	Vismodegib may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Voclosporin	The serum concentration of Dactinomycin can be increased when it is combined with Voclosporin.
Vorapaxar	The serum concentration of Dactinomycin can be increased when it is combined with Vorapaxar.
Vorinostat	The risk or severity of adverse effects can be increased when Dactinomycin is combined with Vorinostat.
Voxilaprevir	The serum concentration of Dactinomycin can be increased when it is combined with Voxilaprevir.
Warfarin	The risk or severity of bleeding can be increased when Warfarin is combined with Dactinomycin.
Ximelagatran	The risk or severity of bleeding can be increased when Ximelagatran is combined with Dactinomycin.
Yellow fever	The risk or severity of infection can be increased when Yellow fever vaccine is combined with Dactinomycin.
Zidovudine	The risk or severity of adverse effects can be increased when Zidovudine is combined with Dactinomycin.
Zonisamide	The serum concentration of Dactinomycin can be increased when it is combined with Zonisamide.

Pregnancy and Lactation

FDA Pregnancy Category B

Pregnancy

This medication should not be used during pregnancy unless the benefits outweigh the risks. Effective birth control should be practiced while using dactinomycin. If you become pregnant while using this medication, contact your doctor immediately.

Lactation

It is not known if dactinomycin passes into breast milk. Women should not breastfeed while receiving dactinomycin treatment due to the risk of potential harm to the infant. Talk to your doctor. This medication should be given to infants only over the age of 6 months.

How should this medicine be used?

Dactinomycin comes as a powder to be mixed with liquid to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. The length of treatment depends on the type of cancer you have, the types of other drugs you are taking, and how well your body responds to treatment. Your doctor may need to stop or delay your treatment if you experience certain side effects. Dactinomycin may also be injected by a doctor directly into a specific part of the body or the organ to treat the area where a tumor is located. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient

Dactinomycin is also sometimes used to treat a type of cancer of the ovaries (cancer that begins in the female reproductive organs where eggs are formed). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before receiving dactinomycin,

tell your doctor and pharmacist if you are allergic to dactinomycin, any other medications, or any of the ingredients in dactinomycin injection. Ask your pharmacist for a list of the ingredients.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
tell your doctor if you have chickenpox or herpes zoster (shingles). Your doctor will probably not want you to receive a dactinomycin injection.
tell your doctor if you have previously received or are currently receiving radiation therapy.
tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant or breast-feed while you are receiving dactinomycin. If you become pregnant while receiving dactinomycin, call your doctor. Dactinomycin may harm the fetus.
do not have any vaccinations without talking to your doctor.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/050682s029s030lbl.pdf
https://pubchem.ncbi.nlm.nih.gov/compound/Dactinomycin
https://pubchem.ncbi.nlm.nih.gov/compound/2019
https://www.drugs.com/mtm/dactinomycin.html
https://go.drugbank.com/drugs/DB00970
https://medlineplus.gov/druginfo/meds/a682224.html
https://en.wikipedia.org/wiki/Dactinomycin
https://www.webmd.com/drugs/2/drug-19921/dactinomycin-intravenous/details/list-contraindications
ChEMBL

http://www.ebi.ac.uk/Information/termsofuse.html

https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL1554/

ChEMBL Protein Target Tree

https://www.ebi.ac.uk/chembl/g/#browse/targets
Comparative Toxicogenomics Database (CTD)

http://ctdbase.org/about/legal.jsp

https://ctdbase.org/detail.go?type=chem&acc=D003609
Drug Gene Interaction database (DGIdb)

http://www.dgidb.org/downloads

https://www.dgidb.org/drugs/DACTINOMYCIN
DrugBank

https://www.drugbank.ca/legal/terms_of_use

Dactinomycin

https://www.drugbank.ca/drugs/DB00970
Therapeutic Target Database (TTD)

Dactinomycin

http://idrblab.net/ttd/data/drug/details/D0P8IV
CAMEO Chemicals

https://cameochemicals.noaa.gov/help/reference/terms_and_conditions.htm?d_f=false

ACTINOMYCIN D

https://cameochemicals.noaa.gov/chemical/19722

CAMEO Chemical Reactivity Classification

https://cameochemicals.noaa.gov/browse/react
ChemIDplus

LICENSE

https://www.nlm.nih.gov/copyright.html

Dactinomycin [USAN:USP:INN:BAN]

https://chem.nlm.nih.gov/chemidplus/sid/0000050760

ChemIDplus Chemical Information Classification

https://chem.nlm.nih.gov/chemidplus/
EPA DSSTox

LICENSE

https://www.epa.gov/privacy/privacy-act-laws-policies-and-resources

Actinomycin D

https://comptox.epa.gov/dashboard/DTXSID9020031

CompTox Chemicals Dashboard Chemical Lists

https://comptox.epa.gov/dashboard/chemical-lists/
European Chemicals Agency (ECHA)

https://echa.europa.eu/web/guest/legal-notice

Dactinomycin

https://echa.europa.eu/substance-information/-/substanceinfo/100.000.058

Dactinomycin

https://echa.europa.eu/information-on-chemicals/cl-inventory-database/-/discli/details/88782
FDA Global Substance Registration System (GSRS)

https://www.fda.gov/about-fda/about-website/website-policies#linking

DACTINOMYCIN

https://gsrs.ncats.nih.gov/ginas/app/beta/substances/1CC1JFE158
Hazardous Substances Data Bank (HSDB)

DACTINOMYCIN

https://pubchem.ncbi.nlm.nih.gov/source/hsdb/3220
Human Metabolome Database (HMDB)

http://www.hmdb.ca/citing

Dactinomycin

http://www.hmdb.ca/metabolites/HMDB0015105

HMDB0015105_msms_2253147

https://hmdb.ca/metabolites/HMDB0015105#spectra
ChEBI

Actinomycin D

http://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:27666

ChEBI Ontology

http://www.ebi.ac.uk/chebi/userManualForward.do#ChEBI%20Ontology
FDA Pharm Classes

https://www.fda.gov/about-fda/about-website/website-policies#linking

DACTINOMYCIN

https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm

FDA Pharmacological Classification

https://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/ucm162549.htm
LiverTox

LICENSE

https://www.nlm.nih.gov/copyright.html

Dactinomycin

https://www.ncbi.nlm.nih.gov/books/n/livertox/Dactinomycin/
LOTUS – the natural products occurrence database

LICENSE

The code for LOTUS is released under the GNU General Public License v3.0.

https://lotus.nprod.net/

LOTUS Tree

https://lotus.naturalproducts.net/
NCI Thesaurus (NCIt)

https://www.cancer.gov/policies/copyright-reuse

https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C412

NCI Thesaurus Tree

https://ncit.nci.nih.gov
CCSbase

DACTINOMYCIN

CCSbase Classification

https://ccsbase.net/
ClinicalTrials.gov

https://clinicaltrials.gov/ct2/about-site/terms-conditions#Use

https://clinicaltrials.gov/
DailyMed

LICENSE

https://www.nlm.nih.gov/copyright.html

DACTINOMYCIN

https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=DACTINOMYCIN
Drug Induced Liver Injury Rank (DILIrank) Dataset

https://www.fda.gov/about-fda/about-website/website-policies#linking

dactinomycin

https://www.fda.gov/science-research/liver-toxicity-knowledge-base-ltkb/drug-induced-liver-injury-rank-dilirank-dataset
The Natural Products Atlas

LICENSE

The Natural Products Atlas is licensed under a Creative Commons Attribution 4.0 International License.

https://www.npatlas.org/terms

Actinomycin D

https://www.npatlas.org/explore/compounds/NPA007563

The Natural Products Atlas Classification

https://www.npatlas.org/
EU Clinical Trials Register

https://www.clinicaltrialsregister.eu/
FDA Orange Book

https://www.fda.gov/about-fda/about-website/website-policies#linking

https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book
National Drug Code (NDC) Directory

https://www.fda.gov/about-fda/about-website/website-policies#linking

DACTINOMYCIN

https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory
International Agency for Research on Cancer (IARC)

https://publications.iarc.fr/Terms-Of-Use

Actinomycin D

https://monographs.iarc.who.int/list-of-classifications

IARC Classification

https://www.iarc.fr/
MassBank of North America (MoNA)

LICENSE

The content of the MoNA database is licensed under CC BY 4.0.

https://mona.fiehnlab.ucdavis.edu/documentation/license

Actinomycin D

https://mona.fiehnlab.ucdavis.edu/spectra/browse?query=compound.metaData%3Dq%3D%27name%3D%3D%22InChIKey%22%20and%20value%3D%3D%22RJURFGZVJUQBHK-IIXSONLDSA-N%22%27
NCI Cancer Drugs

LICENSE

https://www.cancer.gov/policies/copyright-reuse

Cosmegen (Dactinomycin)

https://www.cancer.gov/about-cancer/treatment/drugs/dactinomycin
NIPH Clinical Trials Search of Japan

https://rctportal.niph.go.jp/en/
NLM RxNorm Terminology

https://www.nlm.nih.gov/research/umls/rxnorm/docs/termsofservice.html

dactinomycin

https://rxnav.nlm.nih.gov/id/rxnorm/3100
PubChem

https://pubchem.ncbi.nlm.nih.gov
Springer Nature

https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=90114615-889043108
WHO Anatomical Therapeutic Chemical (ATC) Classification

https://www.whocc.no/copyright_disclaimer/

https://www.whocc.no/atc/

ATC Code

https://www.whocc.no/atc_ddd_index/
WHO Model Lists of Essential Medicines

https://www.who.int/about/who-we-are/publishing-policies/copyright

Dactinomycin

https://list.essentialmeds.org/medicines/83
Wikidata

LICENSE

CCZero

https://creativecommons.org/publicdomain/zero/1.0/

Dactinomycin

https://www.wikidata.org/wiki/Q186127
Wiley

https://pubchem.ncbi.nlm.nih.gov/substance/?source=wiley&sourceid=64721
Medical Subject Headings (MeSH)

https://www.nlm.nih.gov/copyright.html

Dactinomycin

https://www.ncbi.nlm.nih.gov/mesh/68003609

MeSH Tree

http://www.nlm.nih.gov/mesh/meshhome.html

Nucleic Acid Synthesis Inhibitors

https://www.ncbi.nlm.nih.gov/mesh/68019384

Protein Synthesis Inhibitors

https://www.ncbi.nlm.nih.gov/mesh/68011500

Anti-Bacterial Agents

https://www.ncbi.nlm.nih.gov/mesh/68000900

Antibiotics, Antineoplastic

https://www.ncbi.nlm.nih.gov/mesh/68000903
UN Globally Harmonized System of Classification and Labelling of Chemicals (GHS)

GHS Classification Tree

http://www.unece.org/trans/danger/publi/ghs/ghs_welcome_e.html
NORMAN Suspect List Exchange

LICENSE

Data: CC-BY 4.0; Code (hosted by ECI, LCSB): Artistic-2.0

https://creativecommons.org/licenses/by/4.0/

NORMAN Suspect List Exchange Classification

https://www.norman-network.com/nds/SLE/
EPA Substance Registry Services

LICENSE

https://www.epa.gov/privacy/privacy-act-laws-policies-and-resources

EPA SRS List Classification

https://sor.epa.gov/sor_internet/registry/substreg/LandingPage.do
PATENTSCOPE (WIPO)

SID 388454111

https://pubchem.ncbi.nlm.nih.gov/substance/388454111
NCBI

https://www.ncbi.nlm.nih.gov/projects/linkout

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Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

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Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

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Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
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Medicine safety and first-aid guide

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Safe first steps

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Use comfortable posture and gentle movement as tolerated.
Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician

Tests to discuss with doctor

Temperature chart and hydration assessment
CBC with platelet count if fever persists or dengue/other infection is possible
Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

Internal learning pathway

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Article Summary

Key Takeaways

RX Patient Tools

Mechanism of Action

Indications

Use in Cancer

Contraindications

Dosage?

Wilms’ Tumor

Rhabdomyosarcoma

Ewing’s Sarcoma

Testicular Cancer

Trophoblastic Disease

Solid Tumors

Pediatric Dose

Wilms’ Tumor

Rhabdomyosarcoma

Ewing’s Sarcoma

Testicular Cancer

Trophoblastic Disease

Side Effects

The Most Common

More Common

Rare

Drug interactions

Pregnancy and Lactation

Pregnancy

Lactation

How should this medicine be used?

What special precautions should I follow?

Before receiving dactinomycin,

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Prepare before seeing a doctor

Which doctor may help?

What to tell the doctor

Questions to ask

Tests to discuss

Avoid these mistakes

Medicine safety and first-aid guide

Safe first steps

OTC medicine safety

Avoid these mistakes

Get urgent help if

Patient health record and symptom diary

Care roadmap for: Dactinomycin – Uses, Dosage, Side Effects, Interaction

Check danger signs first

Record the symptom story

Visit a qualified clinician

Do only useful tests

Follow up and return early if worse

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