Amsa PD

Amsacrine is a mitotic inhibitor which is often used as a potent antineoplastic agent in patients with acute leukemia and malignant lymphoma. This drug interferes with the growth of cancer cells, which are then eventually destroyed.

Cycling cells are two to four times more sensitive to amsacrine than are resting cells. It binds to DNA through intercalation and external binding and has base specificity for A-T pairs. Cells initially in S and G2 phases are grossly delayed in their capacity for normal progression, leading to an accumulation of cells in the S phase, followed at later times by arrest in the G2 phase.

Although it possesses relatively poor activity in the treatment of solid tumors, it is frequently used in combination with other antineoplastic medications. Further, this drug may produce consistent but acceptable myelosuppression associated with cardiotoxic effects. Thus, amsacrine should be administered only by or under the direct supervision of your doctor.

If you are about to start a drug therapy, the risk-benefit ratio of taking the drug should be considered carefully. This is a decision that your doctor will make with your active participation.

There are some important factors such as

• drug interactions,
• metabolic impairment,
• hypersensitivity reaction,
• pregnancy,
• lactation etc.

which may alter the desired therapeutic effects of such medications.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects.

Make sure you mention your doctor if you have any other health disorders, especially:

• Bone marrow depression or
• Certain severe infections including recent exposure to chickenpox or
• Shingles caused by herpes zoster or
• Cardiac arrhythmias or
• Moderate to severe hepatic or renal diseases.

Certain drugs should not be used simultaneously when you are receiving amsacrine therapy. It is always recommended to consult with your doctor if you are in need of some other medicines for another health disorder so that you can avoid unwanted serious effects.

In addition, following vaccines should not be used together at all:

• Adenovirus Vaccine Type 4, Live
• Adenovirus Vaccine Type 7, Live
• Bacillus of Calmette and Guerin Vaccine, Live
• Influenza Virus Vaccine, Live
• Measles Virus Vaccine, Live
• Mumps Virus Vaccine, Live
• Poliovirus Vaccine, Live
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Typhoid Vaccine
• Varicella Virus Vaccine
• Yellow Fever Vaccine

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of amsacrine in extreme age groups.

Moreover, there are no adequate and well-controlled studies in pregnant as well as lactating women. Thus, this drug can be used in pregnant as well as lactating mothers if clearly needed.

All medicines should be used following the directions given by your doctor.

As amsacrine is usually given to the patients through intravenous route, self-administration is not possible. Thus, it is needed to inject this medicine into the vein of the body by a healthcare professional in a hospital. The dosage schedule of your daily drug administration and the duration of drug therapy may vary with different medical problems for which you are taking the medicine. In addition, the therapeutic dose may be altered with the strength of the medicine as well as patient’s condition or requirement.

Along with desired therapeutic effects, amsacrine often causes nausea and vomiting. However, it is very important that you should not stop receiving this medicine until the prescribed course is finished; even if you begin to feel ill.

It is advised to ask your healthcare professional for ways to lessen these effects.

If you miss any dose of this medicine, you should take it as soon as possible. But if it is time for your next dose, then you should skip the missed dose and go back to your regular treatment schedule.

You should store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. Further, outdated medicines should be disposed by an appropriate way.

You should tell your doctor if you have had any unusual or allergic reaction to this particular medicine or any other medicines.

Additionally, you must not fail to mention if you have any other types of allergies, such as

• to foods,
• dyes,
• preservatives,
• animals.

It is also a matter of concern that amsacrine is working properly or not. Thus, regular visits are strongly recommended so that your doctor can check your progress.

Amsacrine lowers the resistance of the body against various infections by reducing the number of white blood cells, and there is increased chance of being infected. Thus, you should not receive any immunizations (vaccinations) without your doctor's consultation while you are being treated with amsacrine, and even after stopping treatment with it.

This drug is also responsible for decreased number of platelets resulting in impaired blood clotting. Thus, you should take certain precautions in such circumstances to reduce the risk of infection or bleeding, especially when the blood count is below the lower limit of normal range.

Following guidelines may help you to get rid of serious complications:

• You should check with your physician immediately in case of any unusual bleeding or bruising; black-tarry stools; blood in urine; or pinpoint red spots on your skin.

• It is advised to be careful when using a regular toothbrush, dental floss, or toothpick. Your dentist or other healthcare professional may recommend alternative ways to clean your teeth and gums.

• You should consult with your physician before having any surgery (e.g. minor dental surgery).

• Mixing with those people having infections should be avoided. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

• You should not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

• It is advised to avoid contact sports or other situations where bruising or injury could occur.

• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

There are some unwanted side effects associated with each drug that usually do not need medical attention. These side effects usually go away during the treatment episode as your body adjusts to the medicine.

Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted adverse effects.

A patient should check with his/her healthcare professional if any of the following side effects continue:

More common:

• Redness, pain, or swelling at the site of injection
• Burning or tingling feelings
• Numbness of limbs
• Prickling or crawling
• Pins and needles sensation
• Headache
• Black tarry stools
• Blood in urine or stools
• Cough or hoarseness of voice
• Fever or chills
• Lower back pain or side pain
• Painful passage of urine
• Pinpoint red spots on skin
• Unusual bleeding or bruising

Less common:

• Temporary loss of hair
• Gum bleeding
• Difficulty in swallowing
• Hives and rashes
• Loss of appetite
• Lack of strength or energy
• Abdominal pain or tenderness
• Blurred vision
• Bone pain
• Confusion
• Diarrhea
• Dizziness
• Faintness
• Light-headedness
• Irregular heartbeat or pulse
• Palpitations
• Convulsions (seizures)
• Vomiting of blood like material that looks like coffee grounds
• Tender area of infection with accumulation of pus around the rectum
• Sores, ulcers, or white spots on lips, tongue, or inside mouth