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Black Box Warnings .
myocardial damage may lead to CHF as total cumulative doxorubicin dose approaches 550 mg/m^2; include prior anthracycline or anthracenedione use in total cumulative dosage; cardiac toxicity may occur at lower cumulative doses if prior mediastinal irradiation
serious, sometimes life-threatening or fatal allergic/anaphylactoid-like infusion rxns have occurred in up to 11% of pts; may incl. flushing, SOB, facial swelling, headache, rigors, back pain, tightness in chest or throat, and/or hypotension; initial infusion rate of 1 mg/min to minimize rxn risk
Adult Dosing .
Dosage forms: IV
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments
ovarian CA, refractory
- [50 mg/m^2 IV x1 on day 1 of 28-day cycle]
Kaposi sarcoma, AIDS-assoc.
- [20 mg/m^2 IV x1 on day 1 of 21-day cycle]
- [30 mg/m^2 IV x1 on day 4 of 21-day cycle]
- Info: give up to 8 cycles; use w/ bortezomib
- [not defined]
- [see below]
- bilirubin >1.1: decr. dose, amount not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
- hypersens. to drug/class/compon.
- IM or SC admin.
- caution if cardiovascular dz or hx
- caution if myelosuppression
- caution if prior XRT
- caution if prior anthracycline tx
- caution if hepatic impairment
Drug Interactions .
- P-gp substrate
- cardiotoxic effects
- immuno-myelosuppressive chemo
- adenovirus vaccine, live
- BCG live intravesical
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine (live vaccinia virus)
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
- zoster vaccine, live
- radium Ra 223 dichloride
- ado-trastuzumab emtansine
- interferon alfacon-1
- interferon beta 1a
- mycophenolate mofetil
- mycophenolic acid
- anthrax vaccine
- black cohosh
- diphtheria/tetanus and/or pertussis vaccine
- Haemophilus b conjugate vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine (avian flu)
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- pneumococcal vaccine
- poliovirus vaccine
- rabies vaccine
- typhoid vi polysaccharide vaccine
Adverse Reactions .
- injection site rxn, severe
- hand-foot syndrome, severe
- hypersensitivity rxn
- skin rxn, severe
- secondary leukemia
- secondary oral neoplasm (long-term use)
- radiation recall rxn
- hand-foot syndrome
- infusion rxn, acute
- abdominal pain
- back pain
- urine discoloration
- radiation recall rxn
Pregnancy: N/A, see below
use effective contraception during tx and for 6mo after D/C in pts of childbearing potential; weigh risk/benefit in pregnant pts; may incr. risk of fetal harm based on animal studies
LVEF (via MUGA or ECHO) at baseline, then periodically during and after tx; LFTs at baseline; CBC w/ diff prior to each course and frequently thereafter; oral exam
Look/Sound-Alike Drug Names
DOXOrubicin liposomal confused with: DOXOrubicin
Metabolism: liver; CYP450: none; Info: active metabolite, toxic metabolite
Excretion: bile/feces, urine; Half-life: 55h
Subclass: Antibiotic Oncologics 1: Anthracyclines
Mechanism of Action
binds and intercalates into DNA, inhibiting nucleic acid and protein synthesis; triggers DNA cleavage by topoisomerase II
Approximate Retail Price
This information is currently not available for this drug.
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