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Doxorubicin (Adriamycin, Doxil, Rubex)

Warning : The treatment of this drug can come with several side effects. Here are some of the most common things you might experience, but keep in mind that there may be more side effects that you need to discuss with your doctor depending on your individual condition.

Doxorubicin has been associated with causing a serious form of heart disease, and even in some cases, fatal heart failure. Heart disease can occur while undergoing treatment or it might not show up until a long time after you have discontinued treatment. The possibility of this occurring depends on the amount of your dose and any other medical problems you might have. Discuss these details with your physician before proceeding.

 

This medication may also cause you to have an allergic reaction. If you experience any side effect while or after taking this drug, try to get medical assistance as soon as possible.

 

Other common side effects of this medication are blood disorders. Your body may have a reduced ability to stop bleeding or to fight off infections. Be aware of any unchecked bleeding or bruising when you have begun therapy with this drug. Also notice any signs of an infection, such as having chills or fever, sore throat, or tiredness.

 

Indications:  this medication is used to treat cancer by slowing down and in some cases even stopping the growth of cancer cells. Doxorubicin is also called an anthracycline type chemotherapy drug. It can be used alone to treat your cancer or your doctor may prescribe it with other medications. Some medications are designed to help reduce the side effects. It is commonly used to treat breast and ovarian cancers as well as other diseases. It is up to the discretion of your doctor to prescribe this medication for your condition.

In addition, Doxorubicin is a used to treat the following cancers:

  • cervical cancer
  • endometrial cancer
  • head and neck cancer
  • Prostate cancer
  • liver cancer
  • Gestational trophoblastic cancer (GTC)
  • carcinoid tumors
  • non small cell lung cancer
  • multiple myeloma
  • Pancreatic cancer
  • esophageal cancer
  • retinoblastoma
  • hepatoblastoma
  • cancer of the thymus
  • cancer of the adrenal cortex
  • chronic lymphocytic leukemia
  • Ewing’s sarcoma
  • Autoimmune deficiency syndrome (AIDS)–associated Kaposi's sarcoma 

Dosage:  Your physician will determine your dosage amount of this medication. The proper dosage may depend on your existing medical conditions, your body’s size and weight, and your response to therapy. Your doctor or another certified medical professional will inject you with the drug, slowly administering it into your blood stream over a period of thirty to sixty minutes.

 

Contraindications:  Doxorubicine  is not recommended in the following conditions: 

  • Pregancy    
  • breast feeding 
  • kidney failure 
  • measles or flu shots vaccinations  
  • heart disease associated with myocardial failure   
  • allergy to Doxorubicin or any of its components   
  • patients who have low blood counts  
  • Patients who have already received the maximum dose allowed during the lifetime of anthracycline drugs (Daunorubicin, epirubicin, idarubicin, and others) or mitoxantrone. 

Mechanism of action (MOA): Doxorubicin prevents the growth of cancer cells by inhibiting their synthesis of DNA and RNA, a genetic process necessary for reproduction and growth of cells. 

Interactions : Doxorubicin is a potent chemotherapy drug that can be potentially harmful when taken with other inappropriate medicines. Taking certain medications together can decrease the effectiveness of either one, or worsen the side effects you may experience with either one.  You should provide your doctor with a list of medications that you take in order to determine whether it is appropriate for you to take this drug. You should not try to manage your own medication regime.

Talk you your oncologist before taking any of these medicines: 

 

  • Ganciclovir  , an antiviral drug 
  • Amphotericin B, a polyene antifungal drug 
  • Azathioprine  , an immune system inhibitor  
  • Digoxin, a medication used in the treatment of several heart conditions 
  • Plicamycin  , a chemotherapy used to stops the growth of cancer cells 
  • Amiodarone  , a medication used to treat irregular heart beat 
  • Barbiturates,  depressant drug that causes relaxation and sleepiness 
  • Cimetidine  , a drug used to inhibit the production of acid in the stomach 
  • Colchicines  , a medication used to treat pain of gouty arthritis 
  • Cyclophosphamide  (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers 
  • Cyclophosphamide (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers 

Side effects: Despite the beneficial effects of Doxorubicin in the treatment of many cancers, it can damage non-cancerous cells and cause side effects; the most common Doxorubicin side effects include: 

  • nausea
  • vomitting
  • fatigue
  • diarrhea
  • difficulty swallowing
  • hair loss
  • darkened and dry skin
  • decreased appetite
  • weight loss
  • darkening of fingernails or toenails
  • Swelling, pain, redness, or peeling of skin on the palms and soles of the feet 

Doxorubicin e can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:

  • bloody urine  
  • persistent cough  
  • red urine or sweat  
  • shortness of breath or difficulty breathing  
  • persistent diarrhea or constipation   
  • unusual bruising or bleeding  
  • swelling and/or pain at the injection site 
  • sore throat and fever.   

 

References:  

 

1 - ch.oddb.org 

2 - santeontario.com (Doxorubicine) Chlorhydrate pour injection USP 

3 - nlm.nih.gov, Doxorubicin