- Carefully observe patients for evidence of intercurrent or opportunistic infections. Hematologic monitoring is important in immunocompromised patients
- Anthracycline therapy (including daunorubicin) is associated with impaired left ventricular ejection fraction (LVEF). Evaluate cardiac function by means of a history and physical examination before each course of therapy. Determine LVEF at total cumulative doses of 320 mg/m2, and q160 mg/m2 thereafter
- Patients having received prior therapy with anthracyclines (doxorubicin >300 mg/mm2 or equivalent), having pre-existing cardiac disease, or having received previous radiotherapy encompassing the heart are less cardiac tolerant to therapy with this drug. Monitor LVEF at cumulative doses prior to therapy and q160 mg/m2 of daunorubicin
- Triad of back pain, flushing, and chest tightness have occurred. Triad generally develops during the first 5 mins of the infusion, subsides with interruption of the infusion, and generally does not recur on resuming infusion at a slower rate [US Black Box Warning]
- Extravasation at the site of IV administration may induce severe local tissue necrosis
- Perform dosage reduction in patients with impaired hepatic function
- This drug is associated with fetal harm when administered to a pregnant woman. Apprised patients about the potential hazard to the fetus if this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug. Advise women of childbearing potential to avoid becoming pregnant
- Safety have not been established in patients with pre-existing hepatic or renal dysfunction
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Impaired cardiac function
- Myelosuppression
Pregnancy Category:D
Breastfeeding: Unknown whether this drug is excreted in human milk. Potential for serious adverse reactions in nursing infants exists. Manufacturer recommends discontinuing nursing during therapy.
