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Drugs reference index «Adriamycin»

Adriamycin

Generic Name: doxorubicin (Intravenous route)

dox-oh-ROO-bi-sin

Intravenous routeSolutionPowder for Solution

Severe local tissue necrosis will occur if there is extravasation during administration. Doxorubicin must not be given by the intramuscular or subcutaneous route.

Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy. The probability of developing impaired myocardial function based on a combined index of signs, symptoms and decline in left ventricular ejection fraction (LVEF) is estimated to be 1% to 2% at a total cumulative dose of 300 mg/m(2) of doxorubicin, 3% to 5% at a dose of 400 mg/m(2), 5% to 8% at 450 mg/m(2) and 6% to 20% at 500 mg/m(2). The risk of developing congestive heart failure (CHF) increases rapidly with increasing total cumulative doses of doxorubicin in excess of 450 mg/m(2). Risk factors (active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, concomitant use of other cardiotoxic drugs) may increase the risk of cardiac toxicity. Cardiac toxicity with doxorubicin may occur at lower cumulative doses whether or not cardiac risk factors are present. Pediatric patients are at increased risk for developing delayed cardiotoxicity.

Secondary acute myelogenous leukemia (AML) has been reported in patients treated with anthracyclines, including doxorubicin. The occurrence of refractory secondary leukemia is more common when such drugs are given in combination with DNA-damaging anti-neoplastic agents, when patients have been heavily pretreated with cytotoxic drugs, or when doses of anthracyclines have been escalated. The rate of developing treatment-related leukemia was estimated in an analysis of 1474 breast cancer patients who received adjuvant treatment with doxorubicin-containing regimens (i.e., FAC) in clinical trials. The estimated risk of developing treatment-related leukemia at 10 years was 2.5% for the 810 patients receiving radiotherapy plus chemotherapy and 0.5% for the 664 patients receiving chemotherapy alone. The overall risk was estimated at 1.5% at 10 years for the entire patient population. Pediatric patients are also at risk of developing secondary AML.

Dosage should be reduced in patients with impaired hepatic function.

Severe myelosuppression may occur.

Doxorubicin should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents .

Severe local tissue necrosis will occur if there is extravasation during administration; do not administer by the intramuscular or subcutaneous route. Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure (CHF) may occur either during therapy or months to years after termination of therapy. The risk of developing CHF increases rapidly with increasing total cumulative doses of doxorubicin in excess of 450 mg/m(2). Secondary acute myelogenous leukemia has been reported in patients treated with anthracyclines. Reduce dosage in patients with impaired hepatic function. Severe myelosuppression may occur with therapy .

Commonly used brand name(s):

In the U.S.

  • Adriamycin

Available Dosage Forms:

  • Powder for Solution
  • Solution

Therapeutic Class: Antineoplastic Agent

Chemical Class: Anthracycline

Uses For Adriamycin

Doxorubicin belongs to the general group of medicines known as antineoplastics. It is used to treat some kinds of cancers of the blood; lymph system; bladder; breast; stomach; lung; ovaries; thyroid; nerves; kidneys; bones; and soft tissues, including muscles and tendons. It may also be used to treat other kinds of cancer, as determined by your doctor.

Doxorubicin seems to interfere with the growth of cancer cells, which are then eventually destroyed by the body. Since the growth of normal body cells may also be affected by doxorubicin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur until months or years after the medicine is used.

Before you begin treatment with doxorubicin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Doxorubicin is to be administered only by or under the supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, doxorubicin is used in certain patients with the following medical conditions:

  • Autoimmune deficiency syndrome (AIDS)–associated Kaposi's sarcoma (a type of cancer of the skin and mucous membranes that is more common in patients with AIDS)
  • Cancer of the adrenal cortex (the outside layer of the adrenal gland)
  • Cancer of the cervix
  • Cancer of the endometrium
  • Cancer of the esophagus
  • Cancers of the head and neck
  • Cancer of the liver
  • Cancer of the pancreas
  • Cancer of the prostate
  • Cancer of the thymus (a small organ found under the breast bone)
  • Carcinoid tumors
  • Chronic lymphocytic leukemia (a type of cancer of the blood and lymph system)
  • Ewing's sarcoma (a type of cancer found in the bone)
  • Gestational trophoblastic tumors (tumors in the uterus or womb)
  • Hepatoblastoma (a certain type of liver cancer that occurs in children)
  • Multiple myeloma (a certain type of cancer of the blood)
  • Non–small cell lung cancer (a certain type of lung cancer usually associated with prior smoking, passive smoking, or radon exposure)
  • Retinoblastoma (a type of eye cancer found primarily in children)
  • Tumors in the ovaries

Before Using Adriamycin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Heart problems are more likely to occur in children younger than 2 years of age, who are usually more sensitive to the effects of doxorubicin.

Geriatric

Heart problems are more likely to occur in the elderly, who are usually more sensitive to the effects of doxorubicin. The elderly may also be more likely to have blood problems.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Interactions with Medicines

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cisplatin
  • Docetaxel
  • Glucosamine
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Paclitaxel
  • Poliovirus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Stavudine
  • Trastuzumab
  • Typhoid Vaccine
  • Valspodar
  • Varicella Virus Vaccine
  • Warfarin
  • Yellow Fever Vaccine
  • Zidovudine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cyclosporine
  • Phenytoin
  • Sorafenib

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
  • Gout or
  • Kidney stones—Doxorubicin may increase levels of uric acid in the body, which can cause gout or kidney stones
  • Heart disease—Risk of heart problems caused by doxorubicin may be increased
  • Liver disease—Effects of doxorubicin may be increased because of its slower removal from the body

Proper Use of Adriamycin

Doxorubicin is sometimes given together with certain other medicines. If you are receiving a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

Doxorubicin often causes nausea and vomiting. However, it is very important that you continue to receive the medication, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using Adriamycin

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with doxorubicin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Doxorubicin may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine, since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Doxorubicin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

If doxorubicin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Adriamycin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Fast or irregular heartbeat
  • pain at place of injection
  • shortness of breath
  • swelling of feet and lower legs
Rare
  • Black, tarry stools
  • blood in urine
  • pinpoint red spots on skin
  • unusual bleeding or bruising
  • wheezing

Check with your doctor as soon as possible if any of the following side effects occur:

More common
  • Sores in mouth and on lips
Less common
  • Cough or hoarseness accompanied by fever or chills
  • darkening or redness of skin (if you recently had radiation treatment)
  • fever or chills
  • joint pain
  • lower back or side pain accompanied by fever or chills
  • painful or difficult urination accompanied by fever or chills
  • red streaks along injected vein
  • stomach pain
Rare
  • Skin rash or itching

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Nausea and vomiting
Less common
  • Darkening of soles, palms, or nails
  • diarrhea

Doxorubicin causes the urine to turn reddish in color, which may stain clothes. This is not blood. It is to be expected and only lasts for 1 or 2 days after each dose is given.

This medicine often causes a temporary and total loss of hair. After treatment with doxorubicin has ended, normal hair growth should return.

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

  • Fast or irregular heartbeat
  • shortness of breath
  • swelling of feet and lower legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

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  • Adriamycin MedFacts Consumer Leaflet (Wolters Kluwer)
  • Adriamycin Concise Consumer Information (Cerner Multum)
  • Doxorubicin Prescribing Information (FDA)

See Also...

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