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Doxorubicin Dosage

Medically reviewed on January 4, 2017.

Applies to the following strengths: 10 mg; 20 mg; 50 mg; 150 mg; 2 mg/mL; 75 mg; 100 mg

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.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

If the patient has a bilirubin level between 1.2 and 3 mg/dL, the dose should be reduced by 50%. If the patient has a bilirubin level between 3.1 and 5.0 mg/dL, the dose should be reduced by 75%.

Because significant hepatic impairment can increase the risk of toxicity of doxorubicin, evaluating the liver function prior to administration of this drug is recommended. Some experts consider doxorubicin to be contraindicated if this patient's total bilirubin concentration is equal to or greater than 5.0 mg/dL.

Dose Adjustments

The dose of doxorubicin may also depend on whether other cytotoxic agents are to be given. Reference to specific protocols is recommended.

Precautions

US BOXED WARNINGS:
CARDIOMYOPATHY, SECONDARY MALIGNANCIES, EXTRAVASATION AND TISSUE NECROSIS, and SEVERE MYELOSUPPRESSION:
-Cardiomyopathy: This drug can cause myocardial damage, including acute left ventricular failure. The risk of cardiomyopathy is proportional to the cumulative exposure with incidence rates from 1% to 20% for cumulative doses ranging from 300 mg/m2 to 500 mg/m2 when it is administered every 3 weeks. The risk of cardiomyopathy is further increased with concomitant cardiotoxic therapy. Assess left ventricular ejection fraction (LVEF) before beginning therapy and regularly during and after therapy is discontinued.
-Secondary Malignancies: Secondary acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) occur at a higher incidence in patients treated with anthracyclines, including this drug.
-Extravasation and Tissue Necrosis: Extravasation of this drug can result in severe local tissue injury and necrosis requiring wide excision of the affected area and skin grafting. Terminate therapy immediately for extravasation and apply ice to the affected area.
-Severe myelosuppression resulting in serious infection, septic shock, requirement for transfusions, hospitalization, and death may occur.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

It is recommended to closely monitor blood cell counts, cardiac function, serum electrolytes, and susceptibility to infection.

Slow or continuous infusions over hours to days have been associated with less cardiotoxicity than bolus injections.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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