Doxorubicin (Injection)

Introduction

Doxorubicin (dox-oh-ROO-bi-sin)

Treats many kinds of cancers including leukemia, breast cancer, bone cancer, lung cancer, and brain cancer. This medicine is often used in combination with other cancer medicines.

Brand Name(s)

Adriamycin

When This Medicine Should Not Be Used

How to Use This Medicine

Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• The medicine is usually given once every 21 to 28 days. You may also receive other medicines to help prevent nausea and vomiting.
• Do not get the medicine on your skin. If it does, wash the area well with soap and water, and tell your caregiver.
• If you feel stinging or burning in your skin where the needle is placed when the medicine is given, tell your caregiver right away. To relieve any pain or swelling, apply ice to the skin for 15 minutes, 4 times each day. Do this for 3 days. Tell your doctor if you develop blisters, lesions, or other skin changes where the needle was placed.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many other drugs that can cause serious medical problems when used together with doxorubicin. Make sure your doctor knows about all other medicines you are using.
• Make sure your doctor knows if you are also using cyclophosphamide (Cytoxan®, Neosar®), cyclosporine (Neoral®, Sandimmune®), cytarabine (Cytosar®, Depocyt®), paclitaxel (Taxol®), phenobarbital, phenytoin (Dilantin®), progesterone (Crinone®, Prometrium®), steptozocin (Zanosar®), saquinavir (Fortovase®), or verapamil (Calan®, Covera®, Verelan®).
• Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.

Warnings While Using This Medicine

• This medicine can cause birth defects if it is used by the mother while she is pregnant or by the father when his sexual partner becomes pregnant. If a pregnancy occurs while you are using this medicine, tell your doctor right away.
• If you plan to have children, talk with your doctor before using this medicine. Some women using this medicine have become infertile (unable to have children). This medicine may also cause premature menopause.
• Make sure your doctor knows if you have liver disease or heart disease. Tell your doctor if you have received prior chemotherapy or radiation.
• This medicine may turn your urine red for 1 or 2 days after your treatment. This is normal. You may need to protect your clothing from being stained.
• This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
• Some people who have used this medicine have developed a second form of cancer. It is not known if this medicine caused the second cancer to develop. Talk to your doctor about this risk.
• Chemotherapy causes nausea and vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody or black, tarry stools.
• Decrease in how much or how often you urinate.
• Dry mouth, hot and dry skin, dizziness, confusion, extreme thirst.
• Fatigue, fast or uneven heartbeat.
• Fever, chills, cough, sore throat, body aches.
• Rapid weight gain or swelling of hands, ankles, or feet.
• Seizures.
• Shortness of breath, cold sweat, and bluish-colored skin.
• Sores or white patches on your lips, mouth, or throat.
• Uncontrollable vomiting.
• Unusual bleeding or bruising.

If you notice these less serious side effects, talk with your doctor:

• Changes in menstrual periods.
• Darkened skin areas or fingernails.
• Hair loss.
• Nausea, vomiting, diarrhea.
• Weakness or tiredness.

If you notice other side effects that you think are caused by this medicine, tell your doctor

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