Amsacrine (Intravenous)

Amsacrine interferes with the growth of cancer cells in the body so that they can be destroyed by the body, and is a form of chemotherapy for combatting acute adult leukemia.

Overview

Amsacrine interferes with the growth of cancer cells so that they can be destroyed by the body. This form of chemotherapy is suitable only for the treatment of adult leukemia and will have significant side effects on the body. The growth of normal body cells will also be affected by amsacrine, so other side effects will occur. Some of these may be very serious and must be reported to the doctor. Some effects may not occur until months or years after the medicine is taken.

Before beginning treatment with amsacrine, you should discuss both the positives and negatives of the drug with your doctor. The drug is only to be administered under the supervision of a doctor and is injected in a diluted form. Treatment will vary depending on condition, body size, and reaction.

Amsacrine often causes vomiting and nausea but you should continue using the medication nonetheless. Your healthcare professional can advise you on how to minimize the effects, but they will occur when taking this medicine and you should not stop taking this treatment unless instructed to do so by your doctor.

Use of Amsacrine will cause hair loss, however, normal hair growth should usually return once the drug has ceased to be taken.

Condition treated

  • Acute adult leukemia

Type of medicine

  • Chemotherapy

Side Effects

Amsacrine will affect healthy cells as well as cancerous ones, so you should expect to experience side effects. Some side effects that you experience should not require medical attention, but your medical professional may be able to advise you on how to minimize the impact of them on your life. If any of the following occur then this is no cause for concern, but you should inform your doctor if they become bothersome or continue:

  • Headache
  • Nausea
  • Burning
  • Numbness
  • Prickling
  • Pins and Needles
  • Tingling
  • Loss of hair. (Normal hair growth should return after treatment has finished.)

Other side effects are more serious and should be reported immediately if they are experienced.

More common

  • Pus or swollen and tender area of infection around the anus
  • Black stools with an appearance of tar
  • Bloody urine or stools
  • Cough or hoarseness
  • Fever or chills
  • Pain in either the lower back or side
  • Painful or uneasy urination
  • Small spots on the skin
  • Sores and ulcerations
  • Spots on the lips, tongue, or inside mouth
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness

Less common

  • Abdominal pain or tenderness
  • Blurred vision
  • Confusion
  • Dark urine
  • Diarrhea
  • Dizziness, faintness, or light-headedness
  • Fast, pounding, or irregular heartbeat or pulse
  • Fever
  • Itching
  • Nausea
  • Palpitations
  • Convulsions or seizures
  • Vomiting or vomiting of blood or material that looks like coffee grounds
  • Yellow eyes or skin

This list may not be all-inclusive and there may be other side effects experienced. If you do experience any other or unexpected side effects, you should report them to your doctor as soon as possible.

Dosage

This medicine will be utilized intravenously in different doses for different patients. The amount that you take will depend on the strength of the medicine and will be tailored to your body size and the acuteness of the condition that your doctor is trying to treat.

Your doctor will need to check your progress at regular visits to make sure that you are reacting correctly and the drug is working effectively. This will also offer a chance to check for unwanted side effects.

Amsacrine must be diluted before injection.

Transfer of amsacrine is preferred in glass syringes. Plastic syringes can be used as long as the contact period with the syringe is less than 15 minutes.

Interactions

Use of amsacrine with St John's Wort is not usually recommended, but your doctor may prescribe them together in some cases. St John's Wort is an over the counter herbal remedy that has been used for hundreds of years to counteract mental health problems.

Other interactions include:

  • Afatinib
  • Aflibercept
  • Alemtuzumab
  • Anakinra
  • Arsenic trioxide
  • Asparaginase
  • Axitinib
  • Azacitidine
  • Azathioprine
  • Bacillus Calmette-Guérin vaccine
  • Balsalazide
  • Belimumab
  • Bendamustine
  • Bevacizumab
  • Bleomycin
  • Blinatumomab
  • Bortezomib
  • Bosutinib
  • Brentuximab vedotin
  • Busulfan
  • Cabazitaxel
  • Cabozantinib
  • Canakinumab
  • Capecitabine
  • Carbimazole
  • Carboplatin
  • Carfilzomib
  • Carmustine
  • Ceritinib
  • Cetuximab
  • Chlorambucil
  • Cisplatin
  • Cladribine
  • Clofarabine
  • Clozapine
  • Co-trimoxazole
  • Crisantaspase
  • Crizotinib
  • Cyclophosphamide
  • Cytarabine
  • Dabrafenib
  • Dacarbazine
  • Dactinomycin
  • Dasatinib
  • Daunorubicin
  • Decitabine
  • Deferiprone
  • Docetaxel
  • Doxorubicin
  • Epirubicin
  • Eribulin
  • Estramustine
  • Ethosuximide
  • Etoposide
  • Everolimus
  • Fludarabine
  • Fluorouracil
  • Ganciclovir
  • Gefitinib
  • Gemcitabine
  • Hydroxycarbamide
  • Ibrutinib
  • Idarubicin
  • Idelalisib
  • Ifosfamide
  • Imatinib
  • Influenza vaccine
  • Interferon alfa
  • Interferon beta
  • Irinotecan
  • Leflunomide
  • Lenalidomide
  • Linezolid
  • Lomustine
  • Measles, mumps and rubella vaccine, live
  • Melphalan
  • Mercaptopurine
  • Methotrexate
  • Mitomycin
  • Mitotane
  • Mitoxantrone
  • Mycophenolate
  • Nelarabine
  • Nilotinib
  • Nivolumab
  • Obinutuzumab
  • Ofatumumab
  • Olanzapine
  • Olaparib
  • Olsalazine
  • Oxaliplatin
  • Paclitaxel
  • Panitumumab
  • Panobinostat
  • Pazopanib
  • Pegaspargase
  • Peginterferon alfa
  • Peginterferon beta-1a
  • Pemetrexed
  • Pentamidine
  • Pentostatin
  • Pixantrone
  • Pomalidomide
  • Primaquine
  • Procarbazine
  • Propylthiouracil
  • Pyrimethamine
  • Raltitrexed
  • Ramucirumab
  • Regorafenib
  • Rituximab
  • Rotavirus vaccine
  • Ruxolitinib
  • Siltuximab
  • Sorafenib
  • Sulfadiazine
  • Sulfasalazine
  • Sunitinib
  • Temozolomide
  • Temsirolimus
  • Thalidomide
  • Thiotepa
  • Tioguanine
  • Topotecan
  • Trabectedin
  • Trastuzumab emtansine
  • Treosulfan
  • Typhoid vaccine
  • Valganciclovir
  • Varicella-zoster vaccine
  • Vinblastine
  • Vincristine
  • Vindesine
  • Vinflunine
  • Vinorelbine
  • Vismodegib
  • Yellow fever vaccine, live
  • Zidovudine

Discuss the use of tobacco and alcohol with your doctor before taking this medicine.

Other medical problems may affect the use of this medicine. Tell your doctor if you are suffering from any medical issues, including, but not limited to:

  • Bone marrow depression.
  • Infection. These may worsen when you start medication because your body will not be able to fight the infection.
  • Chikenpox, or recent exposure to chickenpox. Amsacrine can increase the chance of infection.
  • Herpes zoster, also known as shingles. There is a severe risk of the disease affecting other body parts.
  • Irregular heartbeat.
  • Kidney disease.
  • Liver disease.
  • Cirrhosis of the liver.
  • Acute alcoholism.
  • HIV.

Warnings

Amsacrine will lower your body's resistance to infection. You should not receive any vaccinations or immunizations while taking this medicine. If you think it is necessary, discuss the options with your doctor before proceeding. There is a chance that you may become infected with the condition that the vaccination is designed to protect you from if you receive it while taking amsacrine.

Family and friends who live with you in the same building should also not take the polio vaccine orally while you are receiving the treatment. Anyone who has received this vaccine within the previous several months could pass this on to you while your immune system is weakened. If you must see people who have, then you may want to wear face protection when you interact with them and keep your distance wherever possible.

Amsacrine can cause scarring if it leaks out of the vein into which it is being injected and into the surrounding tissue. Tell your doctor immediately if you notice swelling, redness or pain at the injection site.

During treatment with Amsacrine, your white blood cell count will lower and this increases the chance of you getting infections. It will also reduce the platelet count in your blood, preventing your blood from clotting properly. This means that both cuts and exposure to infection will be more serious when you are undergoing this treatment. When taking amsacrine you should take the following precautions so that you are not exposed to infection or bleeding:

  • Avoid people who have infections wherever it is possible to do so. If you think you are getting an infection, cough, fever, chills, hoarseness, lower back or side pain or painful or difficult urination, then you should consult your doctor immediately.
  • Inform your doctor immediately if you notice any bleeding, bruising, black stools, bloody urine or red spots on your skin.
  • Be cautious when brushing your teeth and when flossing or using a toothpick. Your dentist can inform you of other ways in which you can practice dental hygiene whilst undergoing this treatment.
  • Avoid making contact between fingers and eyes or the inside of your nose unless you have previously cleaned your hands very thoroughly.
  • Be extra careful to avoid breaking the skin when using knives, nail clippers, razors, and scissors.
  • Avoid situations in which bruising or cuts could occur like contact sports and dangerous activities.

This treatment should not be taken when pregnant. It will harm a baby developing in the womb and it is important not to become pregnant nor father a child while having this treatment and for a few months afterward. You should talk to your doctor about effective contraception before starting this treatment.

Do not breastfeed while undergoing this treatment. The drug may be passed on to your child through the milk. As the drug damages healthy cells, this can be particularly serious in a developing child.

Amsacrine can prevent you from becoming pregnant or fathering a child after treatment. You should discuss this with your doctor and if you think you may wish to have a child in the future you should consider storing sperm or eggs before the treatment starts.

Amsacrine should be used only in adults. Studies in the use of this medicine have not been completed in children.

Storage

Store below 40 °C at all times. Store between 15°C and 30°C where possible. Do not allow to freeze.

Keep away from direct sunlight.

Discard any unused portions.

Summary

Amsacrine is used to combat acute leukemia in adults. It works by attacking newly forming cells and as such it affects both cancerous cells and healthy cells too. As cancerous cells reproduce at a faster rate, the effect is greater on the cancerous cells and the body can eventually destroy the weakened cells.

Amsacrine will have a significant impact on the immune system and can lead to a much greater risk of infection. All vaccinations and immunizations should be avoided and people with any kind of infection should be avoided too. Extra precautions need to be taken in everyday life when taking amsacrine, including when touching the eyes or nose and when brushing teeth.

Amsacrine will cause hair loss and nausea in patients and a wide range of other side effects. Some of these side effects can be signs of significant problems and should be reported to your doctor immediately.

Close monitoring by your doctor will be required while taking amsacrine and regular visits will be required.

The medicine is taken intravenously in a diluted form and is a form of chemotherapy.

Unborn babies can be harmed by the use of amsacrine as can breastfeeding infants. Both males and females should avoid conception during use of the medicine and for several months afterwards and effective contraception plans should be put in place.

Fertility can be affected by the use of amsacrine and it is advised that options are discussed with your doctor before taking the medicine. Freezing sperm or eggs can be advised to enable the possibility of impregnation in the future. This needs collecting before treatment starts.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 04, 2018