WARNING

Doxorubicin is a potent chemotherapy drug used to treat various cancers. While it can be effective, it also poses several risks:

• Cardiotoxicity: Doxorubicin can damage the heart muscle, leading to heart failure or cardiomyopathy. This risk increases with higher doses and cumulative exposure.
• Bone marrow suppression: Doxorubicin can suppress the bone marrow’s ability to produce blood cells, increasing the risk of anemia, infections, and bleeding.
• Gastrointestinal effects: Common side effects include nausea, vomiting, diarrhea, and mouth sores, which can affect a person’s quality of life during treatment.
• Risk of secondary cancers: Long-term use of doxorubicin may increase the risk of developing secondary cancers, such as leukemia.
• Hair loss: Like many chemotherapy drugs, doxorubicin can cause temporary hair loss.
• Nerve damage: Some individuals may experience numbness, tingling, or weakness in the hands and feet (peripheral neuropathy) as a side effect.
• Allergic reactions: Although rare, allergic reactions to doxorubicin can occur, leading to symptoms such as rash, itching, difficulty breathing, and swelling.

It’s essential for patients receiving doxorubicin to be closely monitored by their healthcare team for these potential side effects, and to weigh the benefits of treatment against the risks.

Why is this medication prescribed?

Doxorubicin is a chemotherapy medication primarily used in the treatment of various types of cancer, including breast cancer, bladder cancer, stomach cancer, lung cancer, and Hodgkin’s lymphoma, among others. It belongs to a class of medications called anthracyclines, which work by interfering with the growth and spread of cancer cells in the body.

Doctors may prescribe doxorubicin either alone or in combination with other chemotherapy drugs or treatments, depending on the specific type and stage of cancer being treated.

How should this medicine be used?

Doxorubicin is typically administered intravenously by a healthcare professional in a hospital or clinic setting. The dosage and frequency of administration depend on several factors, including the type and stage of cancer being treated, the patient’s overall health, and any other medications they may be taking.

The dosage is carefully calculated based on the patient’s body surface area or weight to minimize the risk of toxicity while maximizing effectiveness. Treatment schedules may vary, but it’s essential for patients to follow their healthcare provider’s instructions closely and attend all scheduled appointments for monitoring and assessment of treatment response and potential side effects.

It’s crucial for patients to communicate openly with their healthcare team about any concerns or side effects they experience while taking doxorubicin, as adjustments to the treatment plan may be necessary to ensure the best possible outcomes.

Other uses for this medicine

In addition to its primary use in cancer treatment, doxorubicin may also be used off-label for other conditions, such as:

• Soft tissue sarcomas: Doxorubicin may be used to treat certain types of soft tissue sarcomas, such as liposarcoma and leiomyosarcoma.
• Bone cancer: It may be used in the treatment of osteosarcoma, a type of bone cancer.
• Multiple myeloma: Doxorubicin may be used in combination with other medications to treat multiple myeloma, a cancer of the plasma cells.
• Kaposi’s sarcoma: It may be used to treat Kaposi’s sarcoma, a cancer that affects the skin and mucous membranes.

What special precautions should I follow?

As for special precautions when using doxorubicin, here are some important points to consider:

• Heart function monitoring: Doxorubicin can cause heart damage, so patients may need regular cardiac monitoring, including baseline and periodic assessments of heart function through tests like echocardiograms or MUGA scans.
• Blood cell counts: Regular blood tests may be necessary to monitor for signs of bone marrow suppression, including low red blood cell counts (anemia), low white blood cell counts (neutropenia), and low platelet counts (thrombocytopenia).
• Liver function tests: Doxorubicin can affect liver function, so patients may require periodic liver function tests to monitor for signs of liver damage.
• Avoiding pregnancy: Doxorubicin can harm a developing fetus, so women of childbearing age should use effective contraception during treatment and for some time afterward. Men should also use contraception during treatment and for a period afterward, as the drug may be present in semen.
• Preventing exposure: Healthcare providers who handle doxorubicin should take precautions to avoid direct contact with the drug, as it can be absorbed through the skin and cause side effects.

Patients should also be aware of potential drug interactions and inform their healthcare provider of all medications, supplements, and herbal remedies they are taking before starting treatment with doxorubicin.

What special dietary instructions should I follow?

Some general dietary tips include:

• Stay hydrated by drinking plenty of fluids unless otherwise instructed by your healthcare provider.
• Eat a variety of fruits, vegetables, lean proteins, and whole grains to provide essential nutrients.
• Limit processed foods, sugary snacks, and high-fat foods.
• Consider small, frequent meals if you’re experiencing nausea or vomiting as side effects.

What should I do if I forget a dose?

If you forget a dose of doxorubicin, it’s crucial to contact your healthcare provider or oncology team immediately for guidance. Missing a dose can affect the effectiveness of treatment, so they will advise you on the best course of action, which may include rescheduling the missed dose or adjusting your treatment plan as needed. Never try to “catch up” by taking extra doses without consulting your healthcare provider first.

What side effects can this medication cause?

Doxorubicin, like many chemotherapy drugs, can cause a range of side effects. These can vary from person to person and depend on factors such as the dose, duration of treatment, and individual health status. Common side effects of doxorubicin may include:

• Nausea and vomiting: These are among the most common side effects of doxorubicin treatment. Medications to prevent or alleviate nausea and vomiting (antiemetics) may be prescribed.
• Hair loss (alopecia): Doxorubicin can cause temporary hair loss. Hair typically grows back after treatment ends, but it may have a different texture or color.
• Bone marrow suppression: Doxorubicin can affect the bone marrow’s ability to produce blood cells, leading to:
  • Anemia: A decrease in red blood cells, which can cause fatigue and weakness.
  • Neutropenia: A decrease in white blood cells, which increases the risk of infections.
  • Thrombocytopenia: A decrease in platelets, which can result in an increased risk of bleeding or bruising.
• Mouth sores (mucositis): Inflammation and sores in the mouth and throat can occur, making eating and swallowing uncomfortable.
• Loss of appetite: Some individuals may experience a decrease in appetite or changes in taste during treatment with doxorubicin.
• Fatigue: Feeling tired or fatigued is common during chemotherapy treatment, including with doxorubicin.
• Cardiotoxicity: Doxorubicin can damage the heart muscle, leading to cardiomyopathy or heart failure. Regular monitoring of cardiac function is essential during treatment.
• Increased risk of infections: Due to bone marrow suppression, there’s a higher risk of developing infections, which may require prompt medical attention.
• Nail changes: Doxorubicin can cause changes to the nails, such as discoloration or brittleness.
• Skin changes: Some individuals may experience skin changes, such as rash, dryness, or increased sensitivity to sunlight.
• Peripheral neuropathy: Numbness, tingling, or weakness in the hands and feet (peripheral neuropathy) can occur as a side effect of doxorubicin treatment.

It’s important for patients to communicate openly with their healthcare team about any side effects they experience during treatment. Supportive care measures, such as medications to manage symptoms, dietary changes, and lifestyle modifications, may help alleviate some of these side effects and improve overall quality of life during treatment.

What should I know about storage and disposal of this medication?

Storage and Disposal:

Storage:

• Doxorubicin should be stored at room temperature away from light and moisture.
• Keep it out of reach of children and pets.
• Follow any specific storage instructions provided by your healthcare provider or pharmacist.

Disposal:

• Dispose of any unused doxorubicin properly according to local regulations or guidelines.
• Do not flush doxorubicin down the toilet or pour it down the drain unless instructed to do so.
• Consult your healthcare provider, pharmacist, or local waste disposal authority for guidance on safe disposal methods.

In case of emergency/overdose

• In case of an emergency or suspected overdose, contact your local emergency services or poison control center immediately.
• Symptoms of overdose may include severe nausea and vomiting, increased risk of infection due to severe bone marrow suppression, and increased risk of cardiotoxicity.
• Provide as much information as possible about the amount of doxorubicin ingested and any symptoms experienced.

What other information should I know?

• It’s essential to attend all scheduled appointments with your healthcare provider for monitoring during doxorubicin treatment.
• Inform your healthcare provider of any other medications, supplements, or herbal remedies you are taking, as they may interact with doxorubicin.
• Take precautions to avoid exposure to doxorubicin, especially if you are pregnant or breastfeeding.
• Follow your healthcare provider’s instructions closely regarding dosing, scheduling, and any additional supportive care measures.
• Report any new or worsening symptoms to your healthcare provider promptly.

By being informed about storage, disposal, emergency procedures, and other relevant information, you can ensure safe and effective use of doxorubicin as part of your treatment plan.