Daunorubicin

Daunorubicin is used to treat acute leukaemias. It is an anti tumour antibiotic. It works by blocking an enzyme called topoisomerase 2. If this enzyme is blocked, the cell's DNA gets tangled up and the cell cannot split into 2 new cancer cells.

Daunorubicin is a red liquid that you have through a drip into a vein (intravenous infusion). You may have the drug injected into a fast running drip over about 10 minutes. Or you may have it running through the drip over about an hour.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for daunorubicin depends on which cancer you have. There is more about planning chemotherapy in the main chemotherapy section of CancerHelp UK.

We've listed the side effects associated with daunorubicin below. You can use the links (underlined) to find out more about each side effect. Where there is no link please see our cancer drugs side effects section, or click on search at the top of the page.

With this drug, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells - it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) - you may need a blood transfusion
• Bruising more easily due to a drop in platelets - you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Feeling or being sick – is usually well controlled with anti sickness drugs
• Hair loss – everyone treated with this drug will lose their head and body hair
• A sore mouth
• Red urine happens for a couple of days after your injection – it is harmless and will go on its own
• Daunorubicin may have a harmful effect on a developing baby – you should not become pregnant or father a child if you are having this drug. You should talk about contraception with your doctor before having the treatment if there is any possibility you or your partner could become pregnant.
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if this is important to you
• Women may stop having periods (amenorrhoea) – this may only be temporary

Some people have the following side effects

• Skin changes – this drug can make your nails become darker, and can cause an itchy rash and reddening of the skin in areas that have had radiotherapy in the past
• Diarrhoea – drink plenty of fluid and tell your doctor if diarrhoea becomes severe, or continues for more than 3 days
• Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately

A few people may have one of these side effects

• Fever and chills
• Abdominal pain
• Heart damage - daunorubicin can cause temporary damage to the muscles of the heart, which may change the rhythm of the heartbeat. In most cases this will go back to normal after the treatment is completed. You will have heart checks during treatment.

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. 

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - some drugs can react together.

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.