Can You Take Doxorubicin liposomal with Nolvadex?

Talk to your doctor before using tamoxifen with soy products. There is some evidence that substances present in soy may stimulate breast tumor growth and interfere with the action of tamoxifen, although this has not been proven. Whether soy products are effective for hot flashes is also uncertain. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Doxorubicin induces dose-related myelosuppression, primarily affecting leukocytes. Therapy with doxorubicin should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering doxorubicin and the dosage should be reduced. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended. Doxorubicin is contraindicated in patients with severe persistent drug-induced myelosuppression

Precautions and monitoring of patients administered doxorubicin liposomal are the same as those noted for conventional doxorubicin. Doxorubicin can cause myocardial toxicity leading to congestive heart failure. The incidence of drug-induced congestive heart failure in adults is increased when the total cumulative dose of doxorubicin exceeds 550 mg/m2. Patients with preexisting-existing heart disease, prior irradiation, or previous therapy with doxorubicin or related compounds such as daunorubicin, idarubicin or mitoxantrone are at increased risk of cardiotoxicity at a lower cumulative dose. An electrocardiogram, determination of left ventricular ejection fraction, and/or echocardiogram prior to therapy with doxorubicin, at 400 mg/m2 cumulative dose, and periodically thereafter are recommended.

Doxorubicin induces dose-related myelosuppression, primarily affecting leukocytes. Therapy with doxorubicin should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering doxorubicin and the dosage should be reduced. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended. Doxorubicin is contraindicated in patients with severe persistent drug-induced myelosuppression

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

The use of tamoxifen is contraindicated in women with a history of deep vein thrombosis or pulmonary embolus or in women who require concomitant coumarin- type anticoagulant therapy. There is evidence of an increased incidence of thromboembolic events, including deep vein thrombosis and pulmonary embolism, during tamoxifen therapy.

Hematological abnormalities during tamoxifen therapy may include thrombocytopenia, leukopenia, and anemia. Rare hemorrhagic episodes, severe neutropenia and pancytopenia have been reported. Therapy with tamoxifen should be administered cautiously to patients with or predisposed to bone marrow suppression.

Hematological abnormalities during tamoxifen therapy may include thrombocytopenia, leukopenia, and anemia. Rare hemorrhagic episodes, severe neutropenia and pancytopenia have been reported. Therapy with tamoxifen should be administered cautiously to patients with or predisposed to bone marrow suppression.

Endometrial changes such as hyperplasia, polyps, and endometrial cancer have been reported during tamoxifen therapy. Patients should be instructed to immediately report any signs or symptoms of uterine abnormality such as menstrual irregularities, abnormal vaginal bleeding, change in vaginal discharge, or pelvic pain or pressure. Therapy with tamoxifen should be administered cautiously in patients with or history of gynecological abnormalities.

Tamoxifen is extensively metabolized by the liver and excreted in the feces. Alteration in liver enzyme levels have been noted. Severe hepatic injuries such as fatty liver, cholestasis, hepatitis, and hepatic necrosis are rare, however, deaths have been reported. Patients should be instructed to immediately report any sign or symptoms of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with tamoxifen should be administered cautiously in patients with or predisposed to compromised hepatic function.

The pharmacokinetics of doxorubicin liposomal has not been adequately evaluated in patients with hepatic impairment. Doxorubicin is eliminated in large part by the liver. Reduce doxorubicin liposomal injection for serum bilirubin of 1.2 mg/dL or higher.

Corneal changes, cataracts, and retinopathy have been reported during tamoxifen therapy. Therapy with tamoxifen should be administered cautiously in patients with or predisposed to visual disturbances.