Common brand names

• Cerubidine

How it is administered

Daunorubicin is administered intravenously (IV) as part of a liposomal combination with cytarabine. It is supplied as a sterile, preservative-free, purple, lyophilized cake in a single-dose vial. Each vial contains 44 mg daunorubicin and is reconstituted and further diluted before being infused over 90 minutes through a central venous catheter or a peripherally inserted central catheter.

How it works

Daunorubicin is an anthracycline topoisomerase inhibitor. In the liposomal formulation, it is combined with cytarabine at a fixed 1:5 molar ratio, which has shown synergistic effects in killing leukemia cells. Daunorubicin works by forming complexes with DNA, inhibiting the enzyme topoisomerase II, and interfering with DNA polymerase activity. This disrupts the regulation of gene expression and produces DNA-damaging free radicals, ultimately leading to cell death.

In the liposomal form, the drug persists in the bone marrow and is taken up by leukemia cells more than normal cells. After entering the cell, the liposomes release daunorubicin, allowing it to exert its anti-cancer effects directly inside the cancerous cells.

Who should take it

Daunorubicin, in combination with cytarabine as a liposomal injection, is indicated for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.

It is not specifically indicated for lymphoblastic lymphoma, but it is commonly used in the treatment of certain blood cancers, particularly specific types of acute myeloid leukemia. Your healthcare provider will determine if this medication is appropriate for your specific diagnosis.

Who should not take it

You should not take daunorubicin if you have a history of serious hypersensitivity reactions to daunorubicin, cytarabine, or any component of the formulation. It is also not recommended for patients with cardiac function that is less than normal, or those whose lifetime anthracycline exposure has reached the maximum cumulative limit.

Women who are pregnant or planning to become pregnant should avoid this medication, as it can cause fetal harm. If you have Wilson’s disease or other copper-related metabolic disorders, special caution is needed due to the copper content in the formulation.

Commonly used with

Daunorubicin is most commonly used in combination with cytarabine in a fixed ratio as a liposomal formulation for the treatment of certain types of acute myeloid leukemia. It may also be used with other supportive medications such as anti-emetics to manage nausea and medications to prevent infections or bleeding.

Commonly tested with

Daunorubicin is often tested in combination with cytarabine, as this combination has shown synergistic effects in killing leukemia cells. It may also be studied alongside other chemotherapeutic agents or supportive care medications in clinical trials for blood cancers.