Doxorubicin: functions, dosage, side effects, how to use it

Use

What is Doxorubicin used for?

Doxorubicin is a drug solution that belongs to the type of anthraxicline, which is an antibiotic derived from the streptomyces bacteria, which is used to treat cancer. This drug is included in prescription drugs, so you cannot get it over the counter at pharmacies. In addition, drugs that are injected into the body through this vein should be administered by a specialist, such as a doctor or nurse.

The way this drug works doxorubicin is by slowing down or stopping the growth of cancer cells. This drug is primarily used to treat the following cancers:

breast cancer
lung cancer
stomach cancer
ovarian cancer
bladder cancer
white blood cancer (leukemia)
thyroid cancer
cancer that forms in the muscles and bones
cancer that originates from nerve cells (neuroblastoma), usually occurs in children
cancer that originates in the immune system (non-Hodgkin's lymphoma)
Wilms tumor

How do I use Doxorubicin?

There are several things you should know and do when using doxorubicin, namely:

This medication is usually given once over a period of 21 or 28 days.
This medication should be given by a doctor, nurse, or other professional health care provider at a clinic or hospital.
The dose given to the patient must be adjusted to the health condition, weight and height of the patient, as well as the patient's response to therapy carried out to cure cancer.
Have a blood check as recommended by your doctor.
Drink plenty of water while using this medication as this can help the drug flow around the body faster and help reduce any side effects that may arise from taking the medication.

How is Doxorubicin stored?

The right way to store doxorubicin is to put it at room temperature and away from exposure to light and moisture. Avoid storing this drug in the bathroom, let alone storing and freezing it in the freezer. Other brands of this drug may have different ways of storing the drug.

Always read the instructions on the medicine box to better understand how to store the medicine properly. However, if you have any doubts, ask the pharmacist how to store the right medicine. Keep medicines away from children and pets.

Do not flush the medicine in the toilet or throw it into the drain if not instructed by the doctor. Properly discard this product if it is past the deadline or is no longer needed. Consult your pharmacist or local waste disposal agency for more in-depth details on how to safely dispose of the product.

Dose

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Doxorubicin for adults?

Adult dosage for breast cancer

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for neuroblastoma

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dose for non-Hodgkin's lymphoma

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for ovarian cancer

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for Wilms tumor

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for stomach cancer

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for bladder cancer

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for myeloblastic leukemia

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

Adult dosage for thyroid cancer

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

What is the dosage of Doxorubicin for children?

Children's dosage for neuroblastoma

When used as the only drug: 60-75 milligrams (mg) / m2 IV for 3-10 minutes every 21 days.
When used with other drugs: 40-75 mg / m2 IV every 21-28 days.

In what dosage is Doxorubicin available?

Solution, intravenously, as hydrochloride

Adriamycin: 2 milligrams (mg) / milliliter (ml) (5 ml, 10 ml, 25 ml, 100 ml)
Generic: 2 mg / ml (5 ml, 10 ml, 25 ml, 100 ml)

Solution, intravenously, as hydrochloride (preservative free)

Generic: 2 mg / ml (5 ml, 10 ml, 25 ml, 75 ml, 100 ml)

Reconstituted solution, intravenously, as hydrochloride

Adriamycin: 10 mg, 20 mg, 50 mg
Generic: 10 mg, 50 mg

Reconstituted solution, intravenously, as hydrochloride (preservative free)

Generic: 10 mg, 50 mg

Side effects

What side effects can be experienced due to Doxorubicin?

Common side effects that may occur as a result of using this drug are:

serious nausea and vomiting
diarrhea
loss of appetite
red color in urine, tears, and sweat that may last for several days
severe hair loss

Get emergency medical help if you have signs of an allergic reaction: hives difficulty breathing swelling of the face, lips, tongue, or throat.

In addition to the common side effects and allergic reactions, this medication may also cause serious side effects, such as:

The skin feels sore, burning, irritated, or changes color at the injection site
Shortness of breath, even though you are not exerting much energy
Swelling, weight gain very quickly (especially on the face and stomach)
Nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice
Fast, slow, or irregular heartbeat
Anxious, sweating, very short breaths, sighing, panting
Chest pain, cough suddenly, cough with mucus to foam, breathing very fast, coughing up blood
Lower back pain, blood in the urine, less urine or not urinating at all
Numbness or tingling around the mouth, weak pulse, overactive reflexes, frequent confusion, fainting
Muscle weakness, constriction, or contraction
Fever, chills, body aches, flu symptoms, sore mouth and throat
Heartbeat very fast, hard to concentrate
Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red spots under the skin.

Not everyone experiences the serious side effects that have been mentioned. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Precautions & Warnings

What should be known before using doxorubicin?

There are several things you should pay attention to and do before deciding to use this drug, including:

Tell your doctor if you are allergic to doxorubicin, daunorubicin (Cerubidine, DaunoXome), epirubicin (Ellence), idarubicin (Idamycin), any other medicines, or any ingredient in doxorubicin injections. Ask the pharmacist for a list of medicinal ingredients.
Tell me about all prescription and nonprescription drugs, vitamins, nutritional supplements, and herbal products that you are currently using or will be using.
Tell your doctor if you have or have had any other medical conditions.
Because doxorubicin can disrupt the normal menstrual cycle in women and may be able to stop sperm production in men. Therefore, always consult the use of drugs with your doctor to consider the benefits and risks of using this drug.
If medicine gets on your body, immediately and thoroughly wash your skin with soap and water.
If the medicine gets into your eyes, open your eyelids and wash them with as much water as possible for 15 minutes.
Nurses should take care (for example, wearing gloves) to prevent contact with the patient's urine or other body fluids for at least 5 days after treatment.
Do not receive any vaccinations without talking to a doctor.

Is Doxorubicin safe for pregnant and lactating women?

This drug has been shown to cause infertility or sterility in women and men. In fact, in pregnant women, this drug can harm the baby who is in the womb. If you must use this medicine, use the contraceptive pill or other method of birth control to temporarily prevent pregnancy until you are finished using this medicine.

If you become pregnant while using this medicine, contact your doctor immediately. This drug is included in the risk of pregnancy category D according to the US Food and Drug Administration (FDA). The following references the pregnancy risk categories according to the FDA:

A = Not at risk

B = No risk in several studies

C = May be risky

D = There is positive evidence of risk

X = Contraindicated

N = Unknown

While in pregnant women, studies in breastfeeding women have shown harmful effects to the baby. Therefore, you should look for alternative drugs that can be used to treat your health condition. In addition, consult your doctor first about the benefits and risks of using drugs.

If there is no other way than using this medicine to help the healing process of your condition, you should stop breastfeeding so that the medicine you are using is not passed to the baby through breast milk as this can harm your baby.

Interaction

What other medicines may interact with doxorubicin?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Although certain drugs should not be used at the same time, in certain cases, two different drugs can be used together, even if interactions are possible. In this case, your doctor may change the dose, or take other precautions that may be needed. Tell your health care professional if you are taking any other prescription or nonprescription drugs.

Using this medication with the following drugs is not recommended. Your doctor may decide not to treat you with this drug or change some of the other drugs you are taking.

adalimumab
amiodarone
anagrelide
baricitinib
bcg
bepridil
ceritinib
cisapride
deferiprone
dofetilide
droperidol
efarivenz
fingolimod
gatifloxacin
haloperidol
iloperidone
ivabradine
moxifloxacin
nilotinib
osimertinib
pasireotide
pimozide
quinidine

Using this medication with any of the following medicines is usually not recommended, but may be needed in some cases. If the two drugs are prescribed together, your doctor may change the dose or the length of time you take one or both drugs.

abarelix
abiraterone
albuterol
aldesleukin
bendamustine
bexarotene
bicalutamide
bosentan
carboplatin
cisplatin
cladribine
daclatasvir
darunavir
dasatinib
Daunorubicin
deferasirox
eribulin
etravirine
ezogabine

Using this medicine with any of these medicines might increase your risk of certain side effects, but using both drugs may be the best treatment for you. If the two drugs are prescribed together, your doctor may change the dose or the length of time you take one or both drugs.

armodafinil
black cohosh
cinoxacin
delafoxacin
vinblastine
warfarin

Can food or alcohol interact with doxorubicin?

Certain medications should not be consumed at mealtimes or when eating certain types of food because interactions may occur. Consuming alcohol or tobacco-derived products with certain drugs can also cause interactions. Discuss with your health care professional the use of drugs with food, alcohol, or products derived from tobacco.

What health conditions can interact with doxorubicin?

The presence of other medical disorders may affect the use of this drug. Make sure you tell your doctor if you have any other medical problems, especially infections or signs of infection such as:

high fever
sore throat

Overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (119) or immediately to the nearest hospital emergency department. However, because this drug is given by a medical professional who is familiar with the appropriate dosage for your condition, the chances of an overdose are very small.