Advanced Breast Cancer: Learn about treatment options.

doxorubicin

Pronunciation

Generic Name: doxorubicin (DOX oh ROO bi sin)
Brand Name: Adriamycin, Adriamycin RDF, Rubex, Adriamycin PFS

What is doxorubicin?

Doxorubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Doxorubicin is used to treat different types of cancers that affect the breast, bladder, ovary, thyroid, stomach, lungs, bones, nerve tissues, muscles, joints, and soft tissues. Doxorubicin is also used to treat Hodgkin's disease and certain types of leukemia.

Doxorubicin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about doxorubicin?

You should not use this medication if you have an untreated or uncontrolled infection, severe liver disease, severe heart problems, or if you have recently had a heart attack.

Doxorubicin may cause dangerous effects on your heart. Call your doctor at once if you have chest pain, shortness of breath (even with mild exertion), swelling, or rapid weight gain.

Slideshow: Flashback: FDA Drug Approvals 2013

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when doxorubicin is injected. Call your doctor if you have irritation or skin changes where the injection was given.

Doxorubicin can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

Using doxorubicin may increase your risk of developing a bone marrow disease or other types of cancer, such as leukemia.

What should I discuss with my healthcare provider before receiving doxorubicin?

You should not use this medication if you are allergic to doxorubicin or similar medications (doxorubicin, daunorubicin, epirubicin, idarubicin, mitoxantrone), or if you have:

  • an untreated or uncontrolled infection (including mouth sores);

  • severe liver disease;

  • severe heart problems; or

  • if you have recently had a heart attack.

To make sure doxorubicin is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • bone marrow suppression;

  • heart disease; or

  • if you have been treated before with doxorubicin, daunorubicin, epirubicin, idarubicin, or mitoxantrone.

Tell your doctor about all other cancer medicines or radiation treatments you have received in the past.

Using doxorubicin may increase your risk of developing a bone marrow disease or other types of cancer, such as leukemia. Ask your doctor about your specific risk.

FDA pregnancy category D. Do not use doxorubicin if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Doxorubicin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using doxorubicin.

How is doxorubicin given?

Doxorubicin is injected into a vein through an IV. A healthcare provider will give you this injection.

Doxorubicin is sometimes given together with other cancer medications. You may be given other medications to prevent nausea, vomiting, or infections.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when doxorubicin is injected.

If any of this medication accidentally gets on your skin, wash it thoroughly with soap and warm water.

Doxorubicin can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your doxorubicin injection.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while taking doxorubicin?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Do not receive a "live" vaccine while using doxorubicin, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Doxorubicin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, or have a headache, chest tightness, back pain, trouble breathing, or swelling in your face.

Call your doctor at once if you have:

  • feeling short of breath (even with mild exertion), swelling, rapid weight gain;

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • pale skin, easy bruising, unusual bleeding, feeling like you might pass out;

  • fast, slow, or uneven heartbeats;

  • anxiety, sweating, severe shortness of breath, wheezing, gasping for breath;

  • chest pain, sudden cough, cough with foamy mucus, rapid breathing, coughing up blood;

  • lower back pain, blood in your urine, little or no urinating;

  • numbness or tingly feeling around your mouth, weak pulse, overactive reflexes, confusion, fainting;

  • muscle weakness, tightness, or contraction; or

  • pain, burning, irritation, or skin changes where the injection was given.

Doxorubicin may cause your urine to turn a reddish-orange color. This side effect by itself is usually not harmful. However, call your doctor if you also have upper stomach pain, clay-colored stools, or jaundice (yellowing of your skin or the whites of your eyes).

Common side effects may include:

  • missed menstrual periods;

  • darkening of your skin or nails;

  • temporary hair loss;

  • feeling weak or tired;

  • mild nausea, diarrhea; or

  • eye redness, puffy eyelids.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Doxorubicin dosing information

Usual Adult Dose for Breast Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Neuroblastoma:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Hodgkin's Disease:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Ovarian Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Wilms' Tumor:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Stomach Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Acute Lymphoblastic Leukemia:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Lymphoma:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Osteosarcoma:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Bladder Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Acute Myeloblastic Leukemia:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Thyroid Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Bronchogenic Carcinoma:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Soft Tissue Sarcoma:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Multiple Myeloma:

(In combination with other chemotherapeutic agents as a part of the VAD regimen)
9 mg/m2/day IV continuous infusion on days 1 through 4

Usual Pediatric Dose for Malignant Disease:

35 to 75 mg/m2 as a single dose repeated every 21 days, or 20 to 30 mg/m2 once weekly, or 60 to 90 mg/m2 given as a continuous infusion over 96 hours every 3 to 4 weeks.

What other drugs will affect doxorubicin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with doxorubicin, especially:

  • cyclosporine;

  • dexrazoxane;

  • progesterone;

  • saquinavir;

  • verapamil; or

  • seizure medication--phenobarbital, phenytoin.

This list is not complete. Other drugs may interact with doxorubicin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about doxorubicin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.03. Revision Date: 2013-07-08, 11:19:01 AM.

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