What is the chemo drug called the Red Devil?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 27, 2024.

Official Answer by Drugs.com

Overview

The chemotherapy (“chemo”) drug “The Red Devil” is doxorubicin (Adriamycin). It is an intravenous cancer medicine with a clear, bright red color, which is how it got its nickname.
Doxorubicin may also cause your urine or other body fluids to turn a reddish color for 1 to 2 days after a dose is given, which is normal and temporary.
Doxorubicin can cause harsh side effects such as heart toxicity (heart failure), severe nausea and vomiting, and total hair loss (alopecia).
The brand name product Adriamycin has now been discontinued in the U.S., but the generic doxorubicin is still on the market.

Red Devel Chemo Drug

Doxorubicin, in the drug class known as anthracyclines, has been used for decades in the treatment of various solid cancers such as breast cancer and ovarian cancer, or blood cancers like leukemia or lymphoma. It works by inhibiting an enzyme known as topoisomerase 2 and blocking RNA and DNA synthesis, which leads to cell death.

Because of its heart toxicity (cardiotoxicity), doxorubicin has a maximum cumulative dose that can be given to each patient. The higher the total dose you receive over time, the greater your chance for heart side effects. Your doctor will monitor your heart before, during and after doxorubicin treatment. Patients typically receive injections every 21 to 28 days on a specific cycle, but your dose schedule may be different.

You may NOT be able to use doxorubicin if you have severe heart disease or severe liver disease. Contact your doctor right away if you feel extremely weak or tired, have a fast heartbeat, any level of shortness of breath, or swelling in your ankles or feet. A medicine known as dexrazoxane may be used to help protect your heart when receiving Adriamycin.

The liposomal form of doxorubicin (brand name: Doxil) has been developed as an alternative. It cannot be substituted on a mg-for-mg basis with regular doxorubicin. Liposomal doxorubicin is placed inside small fat particles (liposomes) which allows a longer blood circulation time.

Brand and generic forms of doxorubicin and doxorubicin liposomal are available in the U.S.

What are the most common side effects with the Red Devil?

The 3 most common side effects with doxorubicin are hair loss (alopecia), nausea and vomiting. Hair loss was seen in up to 92% of patients, and nausea and vomiting occurred in over 70% of patients. Your doctor will help control your nausea and vomiting with anti-nausea medicine before you receive doxorubicin.

Common side effects of doxorubicin may include:

nausea and vomiting, which can be severe
total hair loss (alopecia) - may fully or partially grow back after treatment
diarrhea
swollen mouth and mouth sores
loss of appetite (anorexia)
shortness of breath
fatigue, extreme tiredness
low platelets (thrombocytopenia)
low white blood cell numbers in the blood (leukopenia), which may increase your risk for infections

Learn more: Doxorubicin Warnings and Side Effects (in more detail)

This is not all the information you need to know about doxorubicin or doxorubicin liposomal for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss any questions you have with your doctor or other health care provider.

References

Doxorubicin prescribing information. Revised 3/2020. New York, NY. Pfizer Inc. Accessed Dec. 7, 2021 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/050467s078,050629s030lbl.pdf
Doxorubicin monograph. Drugs.com. Accessed Dec. 7, 2021 at https://www.drugs.com/mtm/doxorubicin.html
Blanchard S. Can the Red Devil be Tamed? July 12, 2020. Accessed Dec. 7, 2021 at https://moffitt.org/endeavor/archive/can-the-red-devil-be-tamed/

Radiation vs. Chemo: Which cancer treatment is right for you?

Chemotherapy treats cancer throughout the body, while radiation targets specific areas. Each approach has unique benefits depending on the type and stage of cancer, as well as your overall health.

How soon will my hair grow back after chemotherapy?

After finishing chemotherapy, some may notice fine, soft hair appearing as early as 3 to 6 weeks after treatment ends. It can take several months for your hair to return to its previous length and thickness, and there may be temporary changes in texture or color.

Will I lose my hair during chemotherapy treatment?

Chemotherapy-induced hair loss is common and usually temporary, caused by the drugs targeting rapidly dividing hair follicle cells. Hair loss typically starts a few weeks after treatment begins and regrows a few months after it ends.

What is the chemo drug called the Red Devil?

Overview

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What are the most common side effects with the Red Devil?

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