Doxorubicin : Uses, Side Effects, Interactions & More
Doxorubicin should be administered only into a vein. However, it can seep into the surrounding tissue and cause serious damage or irritation. Your doctor or nurse will monitor your administration site to detect this reaction. If you experience any of the following symptoms, call your doctor immediately: pain, itching, redness, swelling, blisters, or sores where the medicine was injected.
Doxorubicin can cause serious or life-threatening heart problems at any time during your treatment or months or years after it ends. Your doctor will order tests before and during your treatment to see if your heart is working well enough that you can safely receive doxorubicin. These tests may include an electrocardiogram (ECG; test that records the electrical activity of the heart) and an echocardiogram (test that uses sound waves to measure the heart’s ability to pump blood). Your doctor may tell you that you should not receive this medicine if you have an abnormal heart rate or if tests show that your heart’s ability to pump blood has decreased. Tell your doctor if you have or have ever had any type of heart disease, heart attack, or radiation therapy (x-ray) in the chest area. Tell your doctor and pharmacist if you are taking or have received certain cancer chemotherapy drugs, such as cyclophosphamide (Cytoxan), daunorubicin (Cerubidine, DaunoXome), epirubicin (Ellence), idarubicin (Idamycin), mitoxantrone (Novantrone), paclitaxel ( Abraxane, Onxol), trastuzumab (Herceptin) or verapamil (Calan, Isoptin). If you experience any of the following symptoms, call your doctor immediately: shortness of breath; labored breathing; swelling of the hands, feet, ankles, or lower legs; or fast, irregular, or pounding heartbeat.
Doxorubicin can cause a severe decrease in the number of blood cells in the bone marrow. Your doctor will order laboratory tests regularly before and during your treatment. A decrease in the number of blood cells in your body can cause certain symptoms and may increase the risk that you will develop an infection or serious bleeding. Tell your doctor and pharmacist if you are taking or have received azathioprine (Imuran), cyclosporine (Neoral, Sandimmune), methotrexate (Rheumatrex), or progesterone (Provera, Depo-Provera). If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, continuous cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; vomiting blood or vomiting blood or brown material that resembles ground coffee.
Doxorubicin may increase your risk of developing leukemia (cancer of the white blood cells), especially when given in high doses or together with certain other chemotherapy and radiation therapy (x-ray) drugs.
Tell your doctor if you have or have ever had liver disease. Your doctor may tell you that you should not receive this medicine or can change your dose if you have liver disease.
Doxorubicin should be administered only under the supervision of a physician experienced in the use of chemotherapy drugs.
Why is this medication prescribed?
Doxorubicin is used in combination with other medications to treat certain types of bladder, breast, lung, stomach, and ovarian cancer; Hodgkin lymphoma (Hodgkin’s disease) and non-Hodgkin lymphoma (cancer that begins in the cells of the immune system); and certain types of leukemia (cancer of the white blood cells), including acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML, ANLL). Doxorubicin is also used alone and in combination with other medications to treat certain types of thyroid cancer and certain types of soft tissue or bone sarcomas (cancer that forms in muscles and bones). It is also used to treat neuroblastoma (a cancer that begins in nerve cells and occurs mainly in children) and Wilms’ tumor (a type of kidney cancer that occurs in children). Doxorubicin belongs to a class of medications called anthracyclines. It works by slowing down or stopping the growth of cancer cells in your body.
How should this medicine be used?
Doxorubicin comes as a solution (liquid) or as a powder to mix with a liquid that a doctor or nurse will inject intravenously (into a vein) at a medical facility. It is usually given once every 21 to 28 days. The length of treatment depends on the types of medications you are taking, how well your body responds to them, and the type of cancer you have.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
Other uses for this medicine
Doxorubicin is also sometimes used to treat cancer of the uterus, the endometrium (lining of the uterus), and the cervix (opening of the uterus); prostate cancer (cancer of a male reproductive organ); pancreatic cancer; adrenocortical cancer (cancer of the adrenal glands); Liver cancer; Kaposi’s sarcoma related to acquired immunodeficiency syndrome (AIDS); Ewing’s sarcoma (a type of bone cancer) in children; mesothelioma (cancer in the lining of the chest or abdomen); multiple myeloma (a type of cancer of the bone marrow); and chronic lymphoblastic leukemia (CLL; a type of cancer of the white blood cells). Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; Ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before receiving doxorubicin injection,
- Tell your doctor and pharmacist if you are allergic to doxorubicin, daunorubicin (Cerubidine, DaunoXome), epirubicin (Ellence), idarubicin (Idamicin), any other medications, or any of the ingredients in doxorubicin injection. Ask your pharmacist for a list of the ingredients.
- Tell your doctor and pharmacist what other prescription and over-the-counter medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the drugs listed in the IMPORTANT WARNING section and any of the following: certain chemotherapy drugs such as cytarabine (DepoCyt), dexrazoxane (Zinecard), mercaptopurine (Purinethol), streptozocin (Zanosar); phenobarbital (luminal sodium); or phenytoin (Dilantin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Other medications may also interact with doxorubicin, so be sure to tell your doctor about all the medications you are taking, even those that are not listed here.
- Tell your doctor if you have or have ever had any other medical conditions.
- You should know that doxorubicin can interfere with the normal menstrual cycle (period) in women and can stop sperm production in men. However, you should not assume that you cannot become pregnant or that you cannot get someone else pregnant. Pregnant or breastfeeding women should inform their doctors before starting this medicine. You should not become pregnant or breastfeed while receiving the doxorubicin injection. If you become pregnant while receiving doxorubicin, call your doctor. Use a reliable method of contraception to prevent pregnancy. Doxorubicin can harm the fetus.
- Don’t get vaccinated without talking to your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What side effects can this medication cause?
Doxorubicin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- sores in the mouth and throat
- loss of appetite (and weight loss)
- weight gain
- stomach pain
- increased thirst
- unusual tiredness or weakness
- hair loss
- separation of fingernail or toenail from the nail bed
- itchy, red, watery, or irritated eyes
- eye pain
- pain, burning, or tingling in the hands or feet
- red discoloration of urine (for 1 to 2 days after dose)
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
- skin rash
- difficulty breathing or swallowing
Doxorubicin may cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.
If you experience a serious side effect, you or your doctor can submit an online report to the Food and Drug Administration (FDA) MedWatch Adverse Event Reporting Program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or cannot wake up, call 911 immediately.
Symptoms of overdose may include the following:
- sores in the mouth and throat
- fever, sore throat, chills, or other signs of infection
- unusual bleeding or bruising
- black and tarry stools
- red blood in stools
- bloody vomit
- vomited material that looks like coffee grounds
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body’s response to doxorubicin.
It is important to keep a written list of all prescription and over-the-counter (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should carry this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
- Hydroxydaunomycin Hydrochloride
- Hydroxydoxorubicin Hydrochloride
Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.