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Amsacrine (Amsidine, m-AMSA)

Amsacrine is a chemotherapy drug. It is also called amsidine or m-AMSA.

It is used to treat acute leukaemia in adults.

How amsacrine works

Chemotherapy drugs work by destroying quickly dividing cells, such as cancer cells.

How you have amsacrine

You have amsacrine into your bloodstream (intravenously). It is a red liquid. 

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

If you don't have a central line

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

When you have amsacrine

You usually have chemotherapy as a course of several cycles of treatment. The chemotherapy drip usually takes about an hour. 

How often you have amsacrine depends on which phase of your treatment you are on.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Diarrhoea

Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.

Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.

Tummy (abdominal) pain 

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Sore mouth

Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.

Redness, swelling or pain at the drip site

Let your nurse know straight away if you have these signs.

Low blood pressure

Tell your doctor or nurse if you feel light headed or dizzy. You have your blood pressure checked regularly.

Changes to liver enzymes in blood tests 

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Discoloration of the skin (purpura)

Talk to your team about this. This might be due to a low platelet count. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

  • increased risk of getting an infection
  • bruising or bleeding, due to low levels of platelets in the blood
  • fits or seizures
  • low potassium levels in the blood- you will have regular blood tests to check for this
  • mood changes
  • heart problems such as change in heart rhythm or changes to how well the heart works - you will have tests to check this
  • shortness of breath
  • changes to how well your liver works - you might have yellowing of the skin or whites of the eyes (jaundice)
  • hair loss
  • skin rash
  • blood in the urine (haematuria) - your nurse will check for this

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • an allergic reaction – tell your nurse or doctor straight away if you have a skin rash, itching, swelling of the lips, face or throat, breathing difficulties, fever and chills.
  • breathlessness and looking pale, due to low red blood cell levels - this is anaemia
  • fluid build up in part of your body (oedema)
  • weight changes
  • lack of energy
  • confusion
  • headaches
  • dizziness
  • reduced sense of touch, or numbness and tingling in fingers or toes (peripheral neuropathy)
  • changes to your vision
  • high levels of protein in your urine, passing very small amounts of urine (anuria) or changes to how well your kidneys work

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception 

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for some time afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Women need to use contracption during treatment and for 3 months afterwards.

Men need to use contraception during treatment and for 6 months afterwards.

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 might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
24 Sep 2020
Next review due: 
24 Sep 2023
  • Electronic Medicines Compendium

    Accessed September 2020

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website