Tuesday 25 October 2011

Doxorubicin


Pronunciation: dox-oh-ROO-bi-sin
Generic Name: Doxorubicin
Brand Name: Adriamycin

Doxorubicin is for intravenous (IV) use only and should only be given under the supervision of a doctor experienced in the use of cancer chemotherapy agents. If Doxorubicin accidentally leaks into surrounding tissue, the skin and/or muscle may be severely damaged. Notify your doctor immediately if redness, pain, or swelling at or around the injection site occur.


Doxorubicin may cause severe and possibly life-threatening heart problems (eg, heart failure). These problems may occur during therapy or sometimes months to years after receiving Doxorubicin. In some cases, heart problems are irreversible. The risk may be increased if you are using certain medicines that may affect heart function (eg, trastuzumab), or have a history of heart problems, radiation treatment to the chest area, or previous therapy with other anthracyclines (eg, epirubicin). The risk of developing heart problems varies depending on your dose and condition, although it can occur at any dose whether or not you are at risk. Notify your doctor immediately if you develop cough; fast, slow, or irregular heartbeat; shortness of breath; sudden, unexplained weight gain; or swelling of the hands, ankles, or feet.


Another type of cancer (acute myelogenous leukemia [AML]) and a certain blood problem (myelodysplastic syndrome [MDS]) have been reported in patients treated with anthracyclines, including Doxorubicin. The risk varies depending on your dose and other medicines and/or radiation therapy. Discuss any questions or concerns with your doctor.


Doxorubicin may cause bone marrow suppression. Notify your doctor immediately if you develop easy bruising or bleeding, unusual tiredness or weakness, or signs of an infection (eg, fever, chills, persistent sore throat).


Tell your doctor if you have liver problems because your dose will have to be decreased. Your doctor will closely monitor you while you are using Doxorubicin.





Doxorubicin is used for:

Treating various types of cancer.


Doxorubicin is an antineoplastic antibiotic. It works by killing cancer cells.


Do NOT use Doxorubicin if:


  • you are allergic to any ingredient in Doxorubicin or to similar medicines (eg, epirubicin)

  • you have certain bone marrow problems (eg, low blood platelet levels, low red blood cell levels, low white blood cell levels)

  • you have severe liver problems

  • you have severe heart problems, severe irregular heartbeat, or recently had a heart attack

  • you have taken or will be taking palifermin within 24 hours before or after using Doxorubicin

Contact your doctor or health care provider right away if any of these apply to you.



Before using Doxorubicin:


Some medical conditions may interact with Doxorubicin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are able to become pregnant

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have swelling or soreness of the mouth or tongue, blood vessel disease, an infection, or liver problems

  • if you plan to receive any vaccines

  • if you are older than 50 years old

  • if you have a history of heart problems or radiation treatment (or are currently receiving radiation treatment), or if you have previously received Doxorubicin or similar medicines (eg, epirubicin, daunorubicin)

  • if you are taking medicines that may affect heart function (eg, calcium channel blockers, trastuzumab). Ask your doctor if you are unsure if any of your medicines may affect heart function

Some MEDICINES MAY INTERACT with Doxorubicin. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Calcium channel blockers (eg, diltiazem, verapamil), cyclophosphamide, or trastuzumab because the risk of heart problems (eg, heart failure) may be increased

  • Cyclosporine, cytarabine, paclitaxel, progesterone, or streptozocin because it may increase the risk of Doxorubicin's side effects

  • Phenobarbital because it may decrease Doxorubicin's effectiveness

  • Anticoagulants (eg, warfarin) because the risk of their side effects may be increased

  • Palifermin because if mouth or tongue sores develop, they may be more severe or last longer

  • Hydantoins (eg, phenytoin) because their effectiveness may be decreased by Doxorubicin

  • Medicines that may harm the liver (eg, acetaminophen, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection) because the risk of Doxorubicin's side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the liver

This may not be a complete list of all interactions that may occur. Ask your health care provider if Doxorubicin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Doxorubicin:


Use Doxorubicin as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Doxorubicin is usually administered as an injection at your doctor's office, hospital, or clinic. Ask your doctor any questions that you may have about Doxorubicin.

  • If Doxorubicin contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.

  • Drinking extra fluids while you are using Doxorubicin is recommended. Check with your doctor for instructions.

  • Your doctor may prescribe another medicine to lessen nausea and vomiting that can occur when using Doxorubicin. Discuss any questions with your doctor.

  • If Doxorubicin accidentally spills on your skin, wash it off immediately with soap and water.

  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.

  • If you miss a dose of Doxorubicin, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Doxorubicin.



Important safety information:


  • Doxorubicin may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor.

  • Doxorubicin may lower your body's ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rash, or chills.

  • Caregivers of children should take precautions (eg, wear latex gloves) to prevent contact with the patient's urine and other body fluids for at least 5 days after treatment.

  • Avoid vaccinations with live virus vaccines (eg, measles, mumps, oral polio) while you are using Doxorubicin. Talk with your doctor before you receive any vaccine.

  • Doxorubicin may cause the urine to turn red. This is harmless and usually goes away 1 to 2 days after receiving a dose of Doxorubicin.

  • Doxorubicin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Doxorubicin. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

  • Lab tests, including liver and kidney function, complete blood cell counts, blood uric acid and electrolyte levels, and heart function, may be performed to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Tell your doctor or dentist that you take Doxorubicin before you receive any medical or dental care, emergency care, or surgery.

  • Use Doxorubicin with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.

  • Caution is advised when using Doxorubicin in CHILDREN; they may be more sensitive to its effects, especially heart problems (eg heart failure) and developing a certain other type of cancer (AML).

  • Doxorubicin may damage sperm. Use effective birth control methods (eg, condoms) while using Doxorubicin. Discuss any questions or concerns with your doctor.

  • Women using Doxorubicin may develop absence of menstrual periods or early menopause.

  • PREGNANCY and BREAST-FEEDING: Doxorubicin has been shown to cause harm to the fetus. Avoid becoming pregnant while you are using it. If you are able to become pregnant, talk with your doctor about using an effective form of birth control. If you become pregnant, discuss with your doctor the benefits and risks of using Doxorubicin during pregnancy. Doxorubicin is excreted in breast milk. Do not breast-feed while using Doxorubicin.


Possible side effects of Doxorubicin:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Diarrhea; hair loss; loss of appetite; nausea; stomach pain; tiredness; weakness; weight changes.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; dizziness; flushed face; tightness in the chest; swelling of the mouth, face, lips, or tongue); absence of menstrual cycle; black, tarry stools; chest pain; fainting; fast, slow, or irregular heartbeat; headache; loose or bloody stools; pain, redness, burning, stinging, swelling, or open sores at the injection site; rectal bleeding or irritation; redness or discharge of the eyes; redness, pain, swelling, peeling, tingling, or blistering of the palms of the hands and the soles of the feet; severe or persistent nausea or vomiting; shortness of breath; sudden, unexplained weight gain; swelling of the hands, ankles, or feet; swelling or soreness of the mouth or tongue; symptoms of dehydration (eg, dry mouth or eyes, decreased urination, fast heartbeat, sluggishness, unusual thirst); symptoms of infection (eg, fever, chills, cough, sore throat, burning or painful urination); unusual bruising or bleeding; unusual tiredness or weakness; vomiting.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.



If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include swelling or soreness of the mouth or tongue; unusual bruising or bleeding.


Proper storage of Doxorubicin:

Doxorubicin is usually handled and stored by a health care provider. If you are using Doxorubicin at home, store Doxorubicin as directed by your pharmacist or health care provider. Keep Doxorubicin out of the reach of children and away from pets.


General information:


  • If you have any questions about Doxorubicin, please talk with your doctor, pharmacist, or other health care provider.

  • Doxorubicin is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Doxorubicin. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Doxorubicin resources


  • Doxorubicin Use in Pregnancy & Breastfeeding
  • Doxorubicin Drug Interactions
  • Doxorubicin Support Group
  • 2 Reviews for Doxorubicin - Add your own review/rating


  • Doxorubicin Prescribing Information (FDA)

  • Adriamycin Prescribing Information (FDA)

  • Doxorubicin Hydrochloride Monograph (AHFS DI)

  • Rubex Prescribing Information (FDA)

  • doxorubicin Concise Consumer Information (Cerner Multum)

  • doxorubicin Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information



Compare Doxorubicin with other medications


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  • Acute Myeloblastic Leukemia
  • Bladder Cancer
  • Breast Cancer
  • Cancer
  • Hodgkin's Lymphoma
  • Lung Cancer
  • Lymphoma
  • Multiple Myeloma
  • Neuroblastoma
  • Osteosarcoma
  • Ovarian Cancer
  • Soft Tissue Sarcoma
  • Stomach Cancer
  • Thyroid Cancer
  • Wilms' Tumor

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