Amsacrine (Amsidine, m-AMSA)
This page tells you about the chemotherapy drug amsacrine and its possible side effects. There is information about
Amsacrine is a chemotherapy drug used to treat some types of
- acute adult leukaemia
It is also called amsidine or m-AMSA.
One of the ways amsacrine works is by blocking an enzyme called topoisomerase 2. If this enzyme is blocked the cell's DNA gets tangled up and the cell can't split into 2 new cancer cells. Amsacrine also works as an alkylating agent. This is a type of chemotherapy drug that works by sticking to one of the cancer cell's DNA strands.
Amsacrine is a red liquid that you have through a drip (intravenous infusion) through a fine tube (cannula) put into one of your veins. The drip takes about an hour. Or you may have amsacrine through a central line, portacath or PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. The tube stays in place throughout the course of treatment.
You usually have this type of chemotherapy as a course of several cycles of treatment. The treatment plan for amsacrine depends on which cancer you are being treated for. You may have amsacrine daily for between 3 and 5 days, every 3 to 4 weeks. There is information about planning chemotherapy in the chemotherapy section.
The side effects associated with amsacrine are listed below. You can use the links to find out more about each side effect. Where there is no link, please see the cancer drug side effects section or use the search box at the top of the page.
More than 10 in every 100 people have one or more of the side effects listed below.
- An 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, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- 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).
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment ends
- A sore mouth and throat – you may have mouth ulcers and red, sore skin inside your mouth 2 to 3 days after each treatment. It usually clears up within 3 weeks
- Feeling or being sick affects 3 out of 10 people (30%) but is usually well controlled with anti sickness medicines
- Your urine may become a pink or red colour for one or two days after treatment but this won't harm you
- Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Women may stop having periods (amenorrhoea) but depending on your age, this may only be temporary
Between 1 and 10 in every 100 people have one or more of these.
- Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
- Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
- Hair loss or thinning
- Abdominal (tummy) pain
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
Fewer than 1 in 100 people have these.
- Temporary damage to the heart muscles, which can affect your heart rhythm – in most people this will go back to normal after the end of treatment
- Very rarely, this drug can cause heart failure so you will have heart tests before you start treatment
- Fits (seizures)
- Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons – this starts within a few days or weeks. It usually goes within a few months of finishing 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 you may develop more side effects 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
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
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, yellow fever and Zostavax (shingles vaccine).
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 to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these 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.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Guide at www.nhs.uk/medicines guide.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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