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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
or
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
