Doxorubicin 2mg/ml Inj, 10ml
WARNING: This drug may cause severe heart problems like heart failure. This can happen during treatment or years after your last dose. Sometimes, this may not go away or may be deadly. The chance may be higher if you have ever had heart problems or chest area radiation. The chance may also be higher if you have ever used this drug, or a drug like this one, or other drugs that may cause heart problems. Ask your doctor if you are not sure if any of your drugs may cause heart problems.The chance of heart problems depends on the dose of this drug and your health problem. In children, the chance of heart problems later in life is higher. Heart problems may happen even without any risk factors. Call your doctor right away if you have cough; chest pain; fast, slow, or abnormal heartbeat; swelling in the arms or legs, shortness of breath; sudden weight gain; or feeling very tired or weak.You will need to have heart function tests while taking this drug. Talk with the doctor. This drug may lower the ability of your bone marrow to make blood cells that your body needs. This can lead to a blood transfusion. Severe and sometimes deadly bleeding problems or infections can also happen. Tell your doctor right away if you have signs of infection like fever, chills, or sore throat; any bruising or bleeding; or if you feel very tired or weak.The risk of a certain bone marrow problem and second cancer (type of leukemia) may be raised after treatment with this drug. If you have questions, talk with the doctor.This drug may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your body. @ COMMON USES: It is used to treat cancer.
Drug Class
Antineoplastic agent
Pharmacologic Class
Anthracycline antibiotic; Topoisomerase II inhibitor; DNA intercalator
Pregnancy Category
D
FDA Approved
Sep 1974
DEA Schedule
Not Controlled
Overview
What is this medicine?
Doxorubicin is a chemotherapy medicine used to treat various types of cancer. It works by stopping cancer cells from growing and multiplying. It is given as an injection into a vein.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Take this medication exactly as directed, and follow all instructions provided. This medication is administered as an intravenous infusion, which means it is given through a vein over a specified period of time.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
If you miss a dose, contact your doctor immediately to receive guidance on what to do next.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
If you miss a dose, contact your doctor immediately to receive guidance on what to do next.
Lifestyle & Tips
- Report any signs of infection (fever, chills, sore throat) immediately, as your immune system will be weakened.
- Avoid contact with people who are sick or have infections.
- Practice good hand hygiene.
- Avoid live vaccines during treatment and for a period after, as your immune system is suppressed.
- Use effective birth control during treatment and for a period after, as this medication can harm a fetus.
- Do not breastfeed during treatment and for a period after.
- You may experience hair loss (alopecia), which is usually temporary.
- Your urine may turn reddish-orange for 1-2 days after treatment; this is normal and harmless.
Available Forms & Alternatives
Available Strengths:
- Doxorubicin 2mg/ml Inj, 5ml
- Doxorubicin 2mg/ml Inj, 10ml
- Doxorubicin 2mg/ml Inj, 25ml
- Doxorubicin 2mg/ml Inj, 100ml
- Doxorubicin Lipo 2mg/ml Inj, 25ml
- Doxorubicin 20/10ml Inj, 10ml
- Doxorubicin 10mg Inj, 1vial
- Doxorubicin Lipo 2mg/ml Inj, 10ml
- Doxorubicin 50mg Inj, 1 Vial
- Doxorubicin 10mg/5ml Inj, 5ml
Dosing & Administration
Adult Dosing
Standard Dose:
Highly variable based on indication and regimen. Common regimens include 60-75 mg/m² IV every 21 days or 20-30 mg/m² IV weekly.
Dose Range:
20 - 75 mg
Condition-Specific Dosing:
Solid Tumors (e.g., breast, ovarian, bladder, lung):
60-75 mg/m² IV as a single dose every 21 days, or 20-30 mg/m² IV weekly.
Lymphomas:
60-75 mg/m² IV every 21 days (often as part of combination regimens like ABVD or CHOP).
Leukemias:
25-30 mg/m² IV daily for 3 days (often in combination).
Pediatric Dosing
Neonatal:
Not established
Infant:
Dosing varies by protocol; typically lower doses than adults, adjusted for body surface area.
Child:
Dosing varies by protocol and indication (e.g., 35-75 mg/m² IV every 21 days or 20-30 mg/m² IV weekly). Cumulative lifetime dose limits apply.
Adolescent:
Dosing varies by protocol and indication; similar to adult dosing based on BSA, with cumulative lifetime dose limits.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment generally required.
Moderate:
No specific dose adjustment generally required.
Severe:
Consider dose reduction (e.g., 75% of normal dose) if CrCl <10 mL/min, though renal excretion is minor. Monitor for increased toxicity.
Dialysis:
Not significantly removed by dialysis. Administer after dialysis. Monitor for increased toxicity.
Hepatic Impairment:
Mild:
Bilirubin 1.2-3.0 mg/dL: Administer 50% of the recommended dose.
Moderate:
Bilirubin >3.0-5.0 mg/dL: Administer 25% of the recommended dose.
Severe:
Bilirubin >5.0 mg/dL: Doxorubicin is generally contraindicated or not recommended due to high risk of severe toxicity.
Confidence:
Medium
Pharmacology
Mechanism of Action
Doxorubicin is an anthracycline cytotoxic agent. Its primary mechanisms of action include: 1. DNA intercalation: It inserts between base pairs of DNA, leading to unwinding of the DNA helix and inhibition of DNA and RNA synthesis. 2. Topoisomerase II inhibition: It stabilizes the topoisomerase II-DNA complex, preventing DNA re-ligation and leading to DNA strand breaks. 3. Free radical formation: It generates highly reactive oxygen free radicals (e.g., superoxide radicals, hydroxyl radicals) that cause oxidative damage to DNA, proteins, and lipids, contributing to both its cytotoxic and cardiotoxic effects.
Pharmacokinetics
Absorption:
Bioavailability:
100% (IV administration)
Tmax:
Not applicable (IV administration)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
20-30 L/m² (large volume of distribution, indicating extensive tissue binding)
ProteinBinding:
74-80%
CnssPenetration:
Limited (does not readily cross the blood-brain barrier)
Elimination:
HalfLife:
Biphasic or triphasic elimination: Initial phase (t½α) 5 minutes, intermediate phase (t½β) 1-3 hours, terminal phase (t½γ) 20-48 hours (doxorubicin) and 30-170 hours (doxorubicinol).
Clearance:
Approximately 35 L/hr/m²
ExcretionRoute:
Primarily biliary/fecal (40-50% as unchanged drug and metabolites); minor renal excretion (5-12%).
Unchanged:
Approximately 5-12% (renal)
Pharmacodynamics
OnsetOfAction:
Rapid (cytotoxic effects are cell cycle non-specific, but maximal effect on S-phase and G2/M phase cells)
PeakEffect:
Not directly quantifiable for cytotoxic effect; plasma concentrations peak immediately after IV infusion.
DurationOfAction:
Effects persist as long as drug is present in tissues; cytotoxic effects are cumulative over treatment cycles.
Safety & Warnings
BLACK BOX WARNING
Doxorubicin is for intravenous use only. Severe local tissue necrosis will occur if there is extravasation during administration. Myelosuppression, primarily leukopenia, requiring careful monitoring of blood counts, is the most common acute dose-limiting toxicity. Cardiotoxicity, including irreversible myocardial damage and/or congestive heart failure (CHF), may occur. The risk of CHF increases with increasing cumulative doses. Secondary malignancies, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), have been reported. Doxorubicin can cause severe nausea, vomiting, and mucositis/stomatitis.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or changed sputum production
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of bleeding, such as:
+ Vomiting or coughing up blood
+ Coffee ground-like vomit
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that get bigger
+ Uncontrollable bleeding
Feeling extremely tired or weak
Special Consideration for Cancer Patients
If you have cancer and are taking this medication, you may be at a higher risk of developing a severe condition called tumor lysis syndrome (TLS), which can be life-threatening. Contact your doctor immediately if you experience:
Fast or abnormal heartbeat
Fainting
Difficulty urinating
Muscle weakness or cramps
Upset stomach, vomiting, diarrhea, or loss of appetite
Feeling sluggish
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only mild ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience:
Hair loss
Diarrhea
Upset stomach or vomiting
Mouth irritation or mouth sores
Changes in nail color or texture
Orange or red urine for 1 to 2 days after receiving this medication
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or changed sputum production
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of bleeding, such as:
+ Vomiting or coughing up blood
+ Coffee ground-like vomit
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that get bigger
+ Uncontrollable bleeding
Feeling extremely tired or weak
Special Consideration for Cancer Patients
If you have cancer and are taking this medication, you may be at a higher risk of developing a severe condition called tumor lysis syndrome (TLS), which can be life-threatening. Contact your doctor immediately if you experience:
Fast or abnormal heartbeat
Fainting
Difficulty urinating
Muscle weakness or cramps
Upset stomach, vomiting, diarrhea, or loss of appetite
Feeling sluggish
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only mild ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience:
Hair loss
Diarrhea
Upset stomach or vomiting
Mouth irritation or mouth sores
Changes in nail color or texture
Orange or red urine for 1 to 2 days after receiving this medication
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Shortness of breath, swelling of ankles/feet, rapid weight gain, or unusual tiredness (signs of heart problems)
- Fever (100.4°F or 38°C or higher), chills, sore throat, or any signs of infection
- Unusual bleeding or bruising
- Severe mouth sores or difficulty swallowing
- Severe nausea, vomiting, or diarrhea that doesn't improve
- Pain, redness, swelling, or blistering at the injection site (signs of extravasation)
- Yellowing of skin or eyes (jaundice)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction and its symptoms.
Existing health conditions, including:
+ Anemia
+ Heart problems
+ Liver disease
+ Low platelet count
+ Low white blood cell count
Recent heart attack
Previous treatment with daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone
Current medications, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins, as some may interact with this medication. Specifically, certain drugs used to treat HIV, infections, seizures, and other conditions should not be taken with this medication.
Pregnancy or potential pregnancy. Do not take this medication during the first trimester of pregnancy.
* Breastfeeding. Avoid breastfeeding while taking this medication, and discuss with your doctor whether you need to avoid breastfeeding for a period after your last dose.
This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, health problems, and concerns to ensure safe treatment. Do not start, stop, or change the dose of any medication without consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction and its symptoms.
Existing health conditions, including:
+ Anemia
+ Heart problems
+ Liver disease
+ Low platelet count
+ Low white blood cell count
Recent heart attack
Previous treatment with daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone
Current medications, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins, as some may interact with this medication. Specifically, certain drugs used to treat HIV, infections, seizures, and other conditions should not be taken with this medication.
Pregnancy or potential pregnancy. Do not take this medication during the first trimester of pregnancy.
* Breastfeeding. Avoid breastfeeding while taking this medication, and discuss with your doctor whether you need to avoid breastfeeding for a period after your last dose.
This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, health problems, and concerns to ensure safe treatment. Do not start, stop, or change the dose of any medication without consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
While on this medication, you may be more susceptible to infections. To minimize this risk, practice good hygiene by washing your hands frequently and avoid close contact with individuals who have infections, colds, or the flu.
Be cautious of bleeding easily, and take steps to prevent injuries. Use a soft-bristled toothbrush and an electric razor to reduce the risk of bleeding. If you experience stomach upset, vomiting, diarrhea, or a decrease in appetite, consult your doctor, as there may be ways to alleviate these side effects.
If side effects such as stomach upset, vomiting, diarrhea, or mouth sores interfere with your ability to eat or drink normally, contact your doctor immediately.
To prevent the transmission of body fluids to family members or caregivers, exercise caution and take necessary precautions. Wash any soiled clothing promptly and wear gloves when handling body fluids for at least 5 days following each treatment.
Before receiving any vaccinations, consult your doctor, as some vaccines may increase the risk of infection or reduce their effectiveness when used in conjunction with this medication.
Regular blood tests will be necessary, as directed by your doctor. Discuss any concerns or questions you may have with your doctor.
If you have a history of or are scheduled to undergo radiation treatment, inform your doctor, as this medication may exacerbate the side effects of radiation therapy.
When administering this medication to children, exercise caution, as they may be at a higher risk of developing low blood sugar.
This medication may affect fertility, potentially leading to difficulties in becoming pregnant or fathering a child. Although fertility may return to normal, it is essential to discuss any concerns with your doctor.
Women may experience cessation of menstrual periods during treatment with this medication, which may or may not resume after treatment. Additionally, women treated with this medication may enter menopause at a younger age than expected. If you have questions or concerns, consult your doctor.
This medication may cause harm to an unborn baby. A pregnancy test will be conducted before initiating treatment to confirm that you are not pregnant. If you or your partner may become pregnant, it is crucial to use birth control while taking this medication and for a specified period after the final dose. Consult your doctor to determine the duration of birth control use. If you or your partner becomes pregnant, notify your doctor immediately.
While on this medication, you may be more susceptible to infections. To minimize this risk, practice good hygiene by washing your hands frequently and avoid close contact with individuals who have infections, colds, or the flu.
Be cautious of bleeding easily, and take steps to prevent injuries. Use a soft-bristled toothbrush and an electric razor to reduce the risk of bleeding. If you experience stomach upset, vomiting, diarrhea, or a decrease in appetite, consult your doctor, as there may be ways to alleviate these side effects.
If side effects such as stomach upset, vomiting, diarrhea, or mouth sores interfere with your ability to eat or drink normally, contact your doctor immediately.
To prevent the transmission of body fluids to family members or caregivers, exercise caution and take necessary precautions. Wash any soiled clothing promptly and wear gloves when handling body fluids for at least 5 days following each treatment.
Before receiving any vaccinations, consult your doctor, as some vaccines may increase the risk of infection or reduce their effectiveness when used in conjunction with this medication.
Regular blood tests will be necessary, as directed by your doctor. Discuss any concerns or questions you may have with your doctor.
If you have a history of or are scheduled to undergo radiation treatment, inform your doctor, as this medication may exacerbate the side effects of radiation therapy.
When administering this medication to children, exercise caution, as they may be at a higher risk of developing low blood sugar.
This medication may affect fertility, potentially leading to difficulties in becoming pregnant or fathering a child. Although fertility may return to normal, it is essential to discuss any concerns with your doctor.
Women may experience cessation of menstrual periods during treatment with this medication, which may or may not resume after treatment. Additionally, women treated with this medication may enter menopause at a younger age than expected. If you have questions or concerns, consult your doctor.
This medication may cause harm to an unborn baby. A pregnancy test will be conducted before initiating treatment to confirm that you are not pregnant. If you or your partner may become pregnant, it is crucial to use birth control while taking this medication and for a specified period after the final dose. Consult your doctor to determine the duration of birth control use. If you or your partner becomes pregnant, notify your doctor immediately.
Overdose Information
Overdose Symptoms:
- Severe myelosuppression (very low blood counts)
- Severe mucositis
- Acute cardiac toxicity
What to Do:
There is no specific antidote for doxorubicin overdose. Management is supportive, including hospitalization, aggressive treatment of myelosuppression (e.g., transfusions, growth factors), and management of cardiac and gastrointestinal toxicities. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Contraindicated Interactions
- Live or attenuated vaccines (due to immunosuppression)
Major Interactions
- Trastuzumab (increased risk of cardiotoxicity)
- Cyclophosphamide (increased risk of cardiotoxicity)
- Paclitaxel (may increase doxorubicin levels if given before doxorubicin)
- Cyclosporine (may increase doxorubicin levels and toxicity)
- Verapamil (may increase doxorubicin levels and toxicity)
- Phenobarbital, Phenytoin (may decrease doxorubicin levels)
- St. John's Wort (may decrease doxorubicin levels)
- Other myelosuppressive agents (additive myelosuppression)
- Other cardiotoxic agents (additive cardiotoxicity)
Moderate Interactions
- Cimetidine (may increase doxorubicin levels)
- Diltiazem (may increase doxorubicin levels)
- Ritonavir (may increase doxorubicin levels)
- Warfarin (potential for altered INR, monitor closely)
- Radiation therapy (may enhance doxorubicin toxicity in irradiated fields)
Minor Interactions
- Not specifically categorized as minor for doxorubicin; most interactions are significant due to narrow therapeutic index.
Monitoring
Baseline Monitoring
Complete Blood Count (CBC) with differential
Rationale: To assess baseline hematopoietic function before initiating myelosuppressive therapy.
Timing: Prior to first dose
Liver Function Tests (LFTs) including bilirubin, AST, ALT, alkaline phosphatase
Rationale: Doxorubicin is primarily metabolized and excreted by the liver; hepatic impairment necessitates dose adjustment.
Timing: Prior to first dose
Renal Function Tests (serum creatinine, BUN)
Rationale: To assess baseline renal function, though renal excretion is minor, severe impairment may warrant caution.
Timing: Prior to first dose
Cardiac Function Assessment (Echocardiogram or MUGA scan to determine Left Ventricular Ejection Fraction - LVEF)
Rationale: Doxorubicin is highly cardiotoxic; baseline LVEF is crucial to assess cardiac reserve and establish a reference point.
Timing: Prior to first dose
Routine Monitoring
Complete Blood Count (CBC) with differential
Frequency: Prior to each dose and periodically during treatment
Target: WBC >3,000-4,000/mm³, ANC >1,500/mm³, Platelets >100,000/mm³ (may vary by protocol)
Action Threshold: Hold dose if ANC <1,500/mm³ or platelets <75,000-100,000/mm³; consider dose reduction or delay.
Liver Function Tests (LFTs)
Frequency: Prior to each dose
Target: Bilirubin <1.2 mg/dL
Action Threshold: Dose reduction or hold if bilirubin elevated (see hepatic impairment dosing).
Cardiac Function Assessment (LVEF by ECHO or MUGA)
Frequency: Periodically during treatment (e.g., every 2-3 cycles or after cumulative dose thresholds are reached, such as 300 mg/m²), and at signs of cardiac dysfunction.
Target: LVEF within normal limits or no significant decline from baseline.
Action Threshold: Hold doxorubicin if LVEF declines significantly (e.g., >10-15% absolute drop from baseline or below 50%) or if signs/symptoms of congestive heart failure develop. Cumulative lifetime dose limit (e.g., 450-550 mg/m²) should be strictly observed.
Symptom Monitoring
- Signs and symptoms of myelosuppression (fever, chills, sore throat, unusual bleeding or bruising, fatigue)
- Signs and symptoms of cardiotoxicity (shortness of breath, swelling of ankles/feet, rapid weight gain, palpitations, chest pain)
- Signs and symptoms of extravasation (pain, burning, swelling, redness at injection site during or after infusion)
- Gastrointestinal symptoms (nausea, vomiting, diarrhea, mucositis/stomatitis)
- Alopecia (hair loss)
- Red-orange discoloration of urine (expected, harmless)
- Fatigue
Special Patient Groups
Pregnancy
Doxorubicin can cause fetal harm when administered to a pregnant woman. It is contraindicated in pregnancy. Women of childbearing potential should be advised to use effective contraception during treatment and for 6 months after the last dose. Men with female partners of childbearing potential should use effective contraception during treatment and for 10 weeks after the last dose.
Trimester-Specific Risks:
First Trimester:
High risk of major birth defects and fetal loss.
Second Trimester:
Risk of fetal harm, including growth restriction and organ toxicity.
Third Trimester:
Risk of fetal harm, including myelosuppression and cardiac effects in the neonate.
Lactation
Doxorubicin is excreted in human milk. Due to the potential for serious adverse reactions in the breastfed infant, breastfeeding is contraindicated during doxorubicin treatment and for at least 10 days after the last dose.
Infant Risk:
High risk of serious adverse effects, including myelosuppression, cardiotoxicity, and potential for carcinogenicity/mutagenicity.
Pediatric Use
Doxorubicin is used in pediatric oncology. Children are at increased risk for delayed cardiotoxicity, especially at younger ages and higher cumulative doses. Long-term monitoring of cardiac function is essential. Secondary malignancies are also a concern.
Geriatric Use
Elderly patients (≥65 years) may be at increased risk for cardiotoxicity and myelosuppression. Careful monitoring of cardiac function and blood counts is crucial. Dose adjustments may be necessary based on individual tolerance and comorbidities.
Clinical Information
Clinical Pearls
- Doxorubicin is a vesicant; ensure proper IV access and monitor closely for extravasation. If extravasation occurs, stop infusion immediately, aspirate residual drug, and consider applying cold packs and administering dexrazoxane (Totect) as an antidote.
- The cumulative lifetime dose of doxorubicin is critical due to dose-dependent cardiotoxicity (typically limited to 450-550 mg/m²). This limit may be lower in patients with pre-existing cardiac disease, prior mediastinal radiation, or concomitant cardiotoxic agents.
- Patients should be informed that their urine may turn red-orange for 1-2 days after administration, which is a harmless effect of the drug's color.
- Severe nausea and vomiting are common; aggressive antiemetic prophylaxis is essential.
- Mucositis/stomatitis can be severe and painful; oral hygiene and supportive care are important.
- Doxorubicin is highly myelosuppressive, with nadir typically occurring 10-14 days after administration. Monitor CBC closely and manage neutropenic fever promptly.
Alternative Therapies
- Other anthracyclines (e.g., Daunorubicin, Idarubicin)
- Other cytotoxic agents used in similar indications (e.g., cyclophosphamide, paclitaxel, cisplatin, etoposide, vincristine)
- Targeted therapies or immunotherapies, depending on the specific cancer type and molecular profile.
Cost & Coverage
Average Cost:
$50 - $200 per 50 mg vial (approximate, highly variable)
Generic Available:
Yes
Insurance Coverage:
Typically covered under medical benefit (Part B) for oncology indications, or pharmacy benefit (Part D) for outpatient use, depending on administration setting. Coverage tier varies by plan.
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the amount, and the time it occurred.