[2] Common side effects include bone marrow suppression, vomiting, mouth ulcers, hair loss, liver problems, infections, and muscle pains.

[16] It was approved by the U.S. Food and Drug Administration (FDA) on December 10, 1964,[17] and launched by Merck Sharp and Dohme under the trade name Cosmegen.

7-AAD binds to single stranded DNA; therefore it is a useful tool in determining apoptosis and distinguishing between dead cells and live ones.

[18] Actinomycin D is composed of a central phenoxazinone chromophore tethered to two identical cyclic peptides and was first structurally characterized by Nuclear Magnetic Resonance (NMR) analysis in 1982.

[19] The biosynthesis of Actinomycin D has been under investigation since its discovery; early fermentation feeding experiments revealed the roles of both tryptophan and D-glutamate as precursor substrates,[20][19] and strain mutagenesis experiments demonstrated that a phenoxazinone synthase enzyme might be responsible for coupling of two moieties of 4-methyl-3-hydroxyanthranilic acid (4-MHA) into the final phenoxazinone structure.

In total, the NRPS assembly line is composed of twenty-two modules, including two each of epimerase and methylase domains.