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Generic Name: DOXOrubicin

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An antibiotic/antineoplastic - treats Hodgkin's Disease, Lymphoma, Acute Myeloblastic Leukemia, Bron... more

FDA Alerts

Extravasation

Severe local tissue necrosis if extravasation occurs. Do not administer IM or sub-Q.

Myocardial Toxicity

Possible cardiotoxicity and potentially fatal CHF during or months to years after therapy; risk of developing CHF increases rapidly with increasing total cumulative dosages >450 mg/m². Toxicity may occur at lower cumulative dosages whether or not risk factors are present. (See Cardiotoxicity under Cautions.)
Probability of developing impaired myocardial function based on combined index of signs, symptoms, and decline in LVEF is estimated to be 1–2, 3–5, 5–8, or 6–20% at total cumulative dosage of 300, 400, 450, or 500 mg/m², respectively.
Risk factors (active or dormant cardiovascular disease, doxorubicin exposure at an early or advanced age, prior or concomitant mediastinal/pericardial irradiation, previous therapy with other anthracyclines or anthracenediones, concomitant use of other cardiotoxic agents) may increase risk of cardiotoxicity.
Pediatric patients are at increased risk for developing delayed cardiotoxicity.
Experience with liposomal doxorubicin at high cumulative dosages is too limited to have established effects on the myocardium; assume myocardial toxicity is similar to that of conventional doxorubicin formulations. Administer to patients with history of cardiovascular disease only when benefits outweigh risk.

Secondary Acute Myelogenous Leukemia (AML)

Possible secondary AML in patients treated with anthracyclines, including doxorubicin; occurrence of refractory secondary leukemia is more common when such drugs are given in combination with other DNA-damaging antineoplastics, after extensive exposure to cytotoxic agents, or when anthracyline dosages have been escalated. (See Mutagenicity and Carcinogenicity under Cautions.)
Pediatric patients are at risk of developing secondary AML.

Infusion-related Effects

Infusion-related reactions (e.g., flushing, shortness of breath, facial swelling, headache, chills, back pain, tightness of chest or throat, hypotension) reported in patients receiving liposomal doxorubicin. Reactions generally resolve within several hours to a day once infusion terminated; may resolve in some patients with slowing of infusion rate.
Serious and sometimes life-threatening or fatal allergic/anaphylactoid-like infusion reactions reported; appropriate therapy and emergency equipment should be available for immediate use.
Administer liposomal doxorubicin at initial rate of 1 mg/minute to minimize risk of infusion reactions.

Myelosuppression

Severe myelosuppression may occur. (See Hematologic Effects under Cautions.)

Hepatic Impairment

Reduce dosage in patients with hepatic impairment. (See Special Populations under Dosage and Administration and also see Hepatic Impairment under Cautions.)

Accidental Substitution

Accidental substitution of liposomal doxorubicin for conventional doxorubicin has resulted in severe adverse effects; do not substitute for conventional doxorubicin on a mg-per-mg basis.

Experience of Supervising Clinician

Administer only under the supervision of qualified clinician experienced in the use of cancer chemotherapeutic agents.

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DOXOrubicin

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What does my medication look like?

Doxorubicin is available with a prescription under the brand name Adriamycin PFS, Adriamycin RDF, and Rubex. Other brand or generic formulations may also be available. Ask your healthcare provider or pharmacist any questions you have about this medication, especially if it is new to you.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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