Doxorubicin Trade name: Adriamycin, Rubex

Chemotherapy drug class: antitumor antibiotics

One of the most powerful chemotherapy drugs invented that is used to treat a wide variety of cancers

FDA approved for use alone or in combination with other drugs

Doxorubicin Treats the following cancers:

Acute lymphoblastic leukemia (ALL)

Acute myeloid leukemia (AML)

Breast Cancer (adjuvant therapy when it has spread to lymph nodes after surgery

Gastric cancer

Hodgkin lymphoma

Neuroblastoma

Non-hodgkin lymphoma

Ovarian cancer

Doxorubicin DOXIL is an anthracycline topoisomerase II inhibitor,

that is encapsulated in STEALTH® liposomes for intravenous use.

Doxorubicin Mechanism Of Action

The mechanism of action is thought to be related to its ability to bind DNA and inhibit nucleic acid synthesis. Cell structure studies have demonstrated rapid cell penetration and perinuclear chromatin binding, rapid inhibition of mitotic activity and nucleic acid synthesis, and induction of mutagenesis and chromosomal aberrations.

Doxorubicin Distribution

Direct measurement of liposomal doxorubicin shows that at least 90% of the drug remains liposome-encapsulated during circulation.

Doxorubicin becomes available after the liposomes are extravasated. Plasma protein binding of DOXIL has not been determined; the plasma protein binding of doxorubicin is approximately 70%.

Doxorubicin Metabolism

Doxorubicinol, the major metabolite of doxorubicin, was detected at concentrations of 0.8 to 26.2 ng/mL in the plasma of patients who received 10 or 20 mg/m² DOXIL.

Elimination

The plasma clearance of total doxorubicin from DOXIL was 0.041 L/h/m² at a dose of 20 mg/m² . Following administration of doxorubicin HCl, the plasma clearance of doxorubicin is 24 to 35 L/h/m² .

Doxorubicin Dosage forms and strengths of doxorubicin hydrochloride:

Vials clear red solution

10 mg/5 mL, 20 mg/10 mL, 50 mg/25 mL, 150 mg/75 mL, and 200 mg/100 mL

Vials red-orange lyophilized powder

10 mg, 20 mg, 50 mg, and 150 mg

Storage

Refrigerated 2° to 8°C (36° to 46°F)

Protect from light

Retain in carton until used

Discard unused portion

Doxorubicin Therapy routine for Breast Cancer, ovary, prostate,

stomach, thyroid; small cell cancer of lung, liver; squamous cell cancer of head and neck; multiple myeloma, Hodgkin's disease, lymphomas, ALL, AML

60-75 mg/m² IV q21Days OR

60 mg/m² IV q14Days OR

40-60 mg/m² IV q21-28Days OR

20 mg/m²/dose qweek

Doxorubicin Limit lifetime cumulative dose to <550 mg/m² to

reduce risk of cardio toxicity (congestive heart failure & cardiomyopathy)

Monitor: CBC, cardiac function, LFTs (liver function tests)

Doxorubicin Side effects:

Nausea or vomiting

Pain at injection site

Temporary Low blood counts of white & red blood cells and platelets

Mouth sores

Alopecia (hair loss on scalp or body)

Eyes watering (first week of treatment)

Urine color red, red-brown, orange, or pink in first 1-2 days after dose administered

Doxorubicin First two weeks of taking drug:

Nail beds darken

Skin darkens where previous radiation treatment was administered

Fertility issues

Serious: can cause issue with pumping of heart that may occur 7-8 years after treatment.

Lifetime limit on amount patients may receive.

Doxorubicin Precautions while taking:

Aspirin and their products should not be taken without physician approval

No vaccinations without physician approval

Use contraceptives (barrier type recommended -condoms) & do not get pregnant

Do not breast feed

Not to be taken by patients with congestive heart failure, if you have already taken high doses of this drug, or have bone marrow suppression or other blood count issues

Doxorubicin Administered:

IV Push (syringe) in not less than 3 to 5 minutes

IVPB (IV admixture) over 15 to 60 minutes

Must not be given via intramuscular or subcutaneous route

Doxorubicin

Refrences http://www.rxlist.com/doxil-drug.htm http://reference.medscape.com/drug/doxorubicin-342120 http://doxorubicin.cancertreatment.net/ http://www.cancer.gov/cancertopics/druginfo/doxorubicinhydrochlori

de http://www.cancernetwork.com/review-article/review-

docetaxeldoxorubicin-combination-metastatic-breast-cancer#sthash.o4sOCNSV.dpuf. Retrieved from cancerNetwork.com: http://www.cancernetwork.com/review-article/review-docetaxeldoxorubicin-combination-metastatic-breast-cancer

http://chemocare.com/chemotherapy/drug-info/doxorubicin.aspx#.VIS15tLF9e8http://www.globalrph.com/doxorubicin.htm#DOSAGE_AND_ADMINISTRATION

http://consumer.healthday.com/encyclopedia/cancer-8/mis-cancer-news-102/chemotherapy-and-side-effects-648006.html

Doxorubicin

Name: Andrew GirgisID no: 40202