amsacrine at a glance
Medicine class
Aminoacridine cytotoxic chemotherapy and topoisomerase II poison
Licensed role
Induction and maintenance of remission in adults with acute leukaemia
Administration
Intravenous infusion in hospital under specialist supervision
Key monitoring
Blood counts, electrolytes, heart rhythm, and liver and kidney function
What is amsacrine used for?
The selected UK product is licensed for adults with acute leukaemia.
Inducing remission in acute leukaemia
Maintaining remission in acute leukaemia
Treatment where anthracycline antibiotics have been ineffective or further use is limited by previous exposure
How does amsacrine work?
Amsacrine inserts between DNA base pairs and interferes with topoisomerase II, an enzyme cells use to manage DNA strands. This promotes DNA breaks and prevents effective DNA replication, preferentially damaging rapidly dividing leukaemia cells.
amsacrine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 75 mg/1.5 mL
How to take amsacrine
Trained hospital staff prepare and administer amsacrine as an intravenous infusion. The concentrate is combined with its supplied solvent and then diluted in glucose solution; saline must not be used because it is incompatible. Leakage outside the vein can cause severe irritation or tissue damage.
It is not taken or prepared at home.
Tell staff immediately about pain, burning, or swelling near the infusion.
Use caution with driving or machinery if adverse effects occur after treatment.
amsacrine side effects
Common or expected effects
- Bone-marrow suppression, increasing risks of infection, anaemia, and bleeding
- Nausea, vomiting, diarrhoea, or abdominal pain
- Sore or ulcerated mouth
- Low blood pressure or low potassium
- Pain or inflammation at the infusion site
- Fever
- Liver-test abnormalities
- Hair loss, rash, or bruising
Get urgent medical advice
- Fever, chills, or other symptoms of infection
- Unexpected bleeding, blood in the urine, or widespread bruising
- Severe mouth inflammation that prevents drinking
- Seizures
- Fast or irregular heartbeat, fainting, or severe breathlessness
- Yellow skin or eyes, markedly reduced urine, or other signs of organ dysfunction
- Severe allergic reaction
- Pain, swelling, inflammation, or tissue damage around the infusion site
amsacrine in pregnancy
Human pregnancy data are inadequate, but amsacrine can damage dividing cells and caused reproductive toxicity in animals. Use during pregnancy is discouraged, particularly during the first trimester, unless a specialist considers that potential benefit outweighs fetal risk. Effective contraception is advised during treatment and afterwards.
amsacrine while breastfeeding
Breastfeeding is contraindicated during amsacrine treatment because transfer into milk is unknown and serious toxicity in the infant is possible. Oncology and maternity teams should advise when breastfeeding can safely resume after chemotherapy.
amsacrine interactions
The oncology team should review prescribed, non-prescribed, and complementary treatments before amsacrine is given.
Vaccines
Responses to influenza and pneumococcal vaccines may be reduced. Live vaccines are generally avoided during clinically significant immunosuppression unless a specialist advises otherwise.
Highly protein-bound medicines
They may displace amsacrine from albumin, increasing free amsacrine concentrations and toxicity.
Other cytotoxic treatments or radiotherapy
Adverse effects, particularly bone-marrow suppression, may be intensified.
Common questions about amsacrine
Answers are fully visible for fast scanning and source review.
What type of chemotherapy is amsacrine?
It is an aminoacridine cytotoxic chemotherapy that damages DNA through DNA intercalation and interference with topoisomerase II.
Why are frequent blood tests needed?
Amsacrine can markedly suppress bone marrow, reducing white cells, platelets, and red cells and increasing risks of infection, bleeding, and anaemia.
Can amsacrine affect the heart?
Yes. Arrhythmias, heart failure, and other cardiac effects have been reported, with greater arrhythmia risk when potassium is low.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.