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My gestational trophoblastic disease didn't respond to Methotrexate so my oncologist will be starting me on Dactinomycin later this week. I will be receiving an IV infusion once every 14 days but am not sure of the exact dosage. I believe I read somewhere that I should pump and dump for 10 days after receiving Dactinomycin. Is this accurate and if so, would it be safe to breast feed my 5 month oldfor a few days in between treatments (days 11-13 of each chemo cycle)? Does the dosage make a difference at all? I am also on coumadin for a pulmonary embolism currently if that potential interaction has any affect. Thanks in advance for your advice.
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Hi, thanks for your post.
I agree, you should pump and dump for 10 days after each infusion. Dosage of the dactinomycin does not matter; this drug undergoes first-order elimination with a half-life of about 36 hours. Seven half-lives (36 hours x 7 = 10.5 days) results in 99% clearance of the drug. It should be safe to BF your baby on days 11-13 of each chemo cycle. There is no interaction between Coumadin and dactinomycin that affects BF safety.
Please post again or call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
-James Abbey, MD
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