Cosmegen® Injection (Dactinomycin) – Potent Cytotoxic Agent for Pediatric and Gestational Malignancies

Buy Cosmegen Injection (Dactinomycin) Online – Wilms Tumor, Rhabdomyosarcoma & Trophoblastic Neoplasia Therapy

Cosmegen injection (dactinomycin) is a powerful cytotoxic antibiotic used in combination chemotherapy to treat Wilms tumor, rhabdomyosarcoma, Ewing sarcoma, metastatic testicular cancer, and gestational trophoblastic neoplasia. It works by binding DNA and inhibiting RNA synthesis, leading to cell death in rapidly dividing cancer cells.

Brand Name: Cosmegen®

Generic Name: Dactinomycin (Actinomycin D)

Drug Class: Antineoplastic antibiotic / DNA intercalator

Formulation: Lyophilized powder for intravenous injection (0.5 mg/vial)

Prescription Status: Rx only

Manufacturer: Recordati Rare Diseases, various generics

Order Cosmegen Injection – EZ Chemist Pharmacy

Dactinomycin (Actinomycin D) – A member of the actinomycin antibiotic family

Other names: Dactinomycin for Injection, Actinomycin D, Cosmegen

Dactinomycin intercalates between guanine–cytosine DNA base pairs, inhibiting RNA polymerase, preventing RNA and protein synthesis. This action induces apoptosis in rapidly dividing cancer cells. It also generates free radicals, further damaging DNA and cell membranes.
Cosmegen is indicated for:

Wilms tumor (pediatric) in multi-phase regimens

Rhabdomyosarcoma, including pediatric cases

Ewing sarcoma (adolescent and adult)

Metastatic nonseminomatous testicular cancer, in cisplatin-containing chemotherapy

Gestational trophoblastic neoplasia (low/high risk), as single agent or in combination

Regional limb perfusion (lower/upper extremity) with melphalan for soft tissue malignancies ◎

Dosing varies by indication and patient age:

Wilms Tumor: 45 µg/kg IV once every 3–6 weeks, up to 26 weeks

Rhabdomyosarcoma: 15 µg/kg IV daily × 5 days every 3–9 weeks, up to 112 weeks

Ewing Sarcoma: 1,250 µg/m² IV once every 3 weeks for 51 weeks

Testicular Cancer: 1,000 µg/m² IV every 3 weeks in cisplatin-based protocols

Gestational Neoplasia (low risk): 12 µg/kg IV daily × 5 days

High-risk GTN: 500 µg IV Days 1 & 2 every 2 weeks, up to 8 weeks

Regional perfusion: 50 µg/kg (lower limb), 35 µg/kg (upper limb) with melphalan ◎
PDR.net

Reconstitute with 1.1 mL sterile water, dilute to ≥10 µg/mL with saline or dextrose, infuse IV over 10–15 mins, discard unused within 4 hrs. Special handling required due to cytotoxicity ◎

Administer under oncologist supervision; handle per cytotoxic protocols in biological safety cabinets ◎
FDA Access Data

Contraindications: Hypersensitivity to dactinomycin; active chickenpox or herpes zoster infections due to risk of fatal complications ◎

Monitor WBC, platelets, liver enzymes (AST), signs of veno-occlusive disease (VOD) especially post-radiation or in hepatic malignancies ◎

Myelosuppression: Anemia, neutropenia, thrombocytopenia (dose-limiting) ◎

Gastrointestinal toxicity: Mucositis, stomatitis, nausea, vomiting, diarrhea, esophagitis, increased liver enzymes ◎

Dermatologic effects: Alopecia, rash; risk of radiation recall dermatitis ◎

Organ toxicity: Hepatotoxicity including liver failure, VOD, pulmonary toxicity, pneumonitis ◎

Others: Fever, infection, peripheral neuropathy, optical and renal complications ◎
Mayo Clinic

Highly toxic vesicant: Monitor for extravasation; apply ice, surgical consultation if needed
FDA Access Data
FDA Access Data

Myelosuppression: Frequent CBC monitoring required

Infection risk: Avoid live vaccines during treatment

Radiation recall: Use caution if prior region-specific radiation

Hepatic/renal impairment: Dose adjustments or treatment delays may be needed

Cisplatin-based regimens: Enhanced nephrotoxicity/myelosuppression; hydration and electrolyte monitoring essential

Cyclophosphamide, bleomycin, vinblastine: Multi-agent chemotherapy synergy and cumulative toxicity
GlobalRPH

ATC Code: L01DA02

Pharmacologic Class: Antineoplastic antibiotic, cytotoxic

Prescription Status: Rx only, cytotoxic drug with restricted handling protocols

Clinical Evidence
Pediatric Wilms Tumor protocols: Included in multimodal regimens with high remission and survival rates

Ewing Sarcoma and Rhabdomyosarcoma: Part of standardized protocols, including US‑intergroup regimens

Gestational trophoblastic neoplasia: Immune response >90% complete remission in high-risk EMA‑CO/EMA‑EP protocols

Frequently Asked Questions (FAQs)
Q1. What cancers does Cosmegen treat?
It treats Wilms tumor, rhabdomyosarcoma, Ewing sarcoma, metastatic testicular cancer, and gestational trophoblastic neoplasia in multi-agent protocols
FDA Access Data

Q2. How is Cosmegen given?
IV infusion over 10–15 mins; doses and schedules vary by cancer type. Must be prepared in a safe cytotoxic environment
FDA Access Data

Q3. What are the main side effects?
Primary toxicities include bone marrow suppression, mucositis, alopecia, liver toxicity, and vesicant extravasation risk

Q4. What monitoring is needed?
Frequent CBCs, LFTs, infection monitoring, site monitoring for extravasation; avoid live vaccines.

Q5. Can it be used alone?
Yes for low-risk trophoblastic neoplasia, but most conditions require combination chemotherapy protocols
FDA Access Data

Storage & Handling
Store vials at 20–25°C, protect from light and humidity ◎
GlobalRPH

Handle in Class II biosafety cabinet; use PPE to avoid skin/mucous contact; cytotoxic disposal per guidelines. Avoid use during pregnancy due to mutagenic/teratogenic risk ◎
FDA Access Data

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