Adriamycin PFS

Brand Name:Adriamycin PFS, Doxorubicin HCl for Injection US, Doxorubicin Hydrochloride Injection USP, Myocet, Caelyx

Prescription needed: Yes

What is this drug used for?

Doxorubicin is primarily used (alone or in combination with other medications) to treat different types of cancer including cancer of the blood, lymph nodes (e.g. Hodgkin’s disease) as well as cancer of the bladder, breast, lung, ovaries, testicles, bone, stomach and thyroid gland. It has also been used to treat a cancer that is seen with AIDS, known as Kaposi’s sarcoma.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to doxorubicin, epirubicin, daunarubicin, mitoxantrone, or mitomycin C. It should be avoided if you have been treated before with the maximum amount of this medication or other similar medications. Tell your doctor if you have had or have ever had:

  • a recent heart attack or severe problems with your heart (e.g. congestive heart failure)
  • problems with heart rhythm
  • problems with your immune system such as low white blood cells (e.g. leukopenia)
  • problems with your kidney (including kidney stones) or liver
  • chicken pox or shingles (herpes zoster)
  • problems with frequent infections
  • high levels of uric acid in the blood or a condition called Gout
  • used other medications for cancer or radiation therapy

What about possible side effects?

The most common side effects are:

  • not feeling hungry, nausea and vomiting
  • hair loss (regrowth will occur)
  • sores or ulcers in your mouth
  • a condition called leukopenia: call your doctor immediately if you experience unexplained sore throat, fever, chills, or other signs of infection
  • red colour to urine (for 1-2 days in beginning)

Other less common and possibly severe side effects include:

  • problems with the heart (heart rhythm abnormalities, congestive heart failure) - can occur during or after therapy; if problems occur, they are usually found in those who have risk factors or who receive higher doses
  • skin irritations, rashes, burning - sometimes at the spot where you may have received radiation
  • darkened skin or nails
  • cases of hepatitis (inflammation of the liver) and jaundice (yellowing of skin and eyes) have been reported - call your doctor if you experience unexplained nausea, vomiting, stomach pain, fatigue, loss of appetite, dark urine, yellowing of the skin and/or eyes
  • blood in urine or pain when urinating - if this occurs, it is usually in people who are having medication administered directly into the bladder
  • a decrease in sperm count (this can be permanent with long-term therapy)
  • changes in menstrual cycle, loss of monthly period
  • increased chance for a certain blood cancer called leukemia - rare and with longer-term therapy or with other drugs that can change the body’s immune system

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • live vaccines - may increase the chances for infection
  • other vaccines - may decrease the body’s ability to develop an immunity to the vaccine(s)
  • zidovudine
  • phenytoin, carbamazepine
  • glucosamine
  • other medications for cancer - increases your chances for some side effects
  • cyclosporine
  • cyclophosphamide - increased chance for side effects to bladder
  • digoxin
  • verapamil, dilitiazem
  • ciprofloxacin, levofloxacin, gatifloxacin and other similar antibiotics

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

As this drug decreases how well your body’s immune system can work, you will become more susceptible to infections. Call your doctor if you have any signs of infection such as fever, sore throat, muscle aches, etc. while you are taking this medication. If you are exposed to chicken pox, measles or tuberculosis while taking this drug, tell your doctor.

Vaccines: Due to the increased risk of infection both during and after treatment with this drug, it is important not to have any vaccinations or skin tests without first talking to your doctor. Some vaccines are not recommended.

Family members living in the same household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid anyone who has recently taken oral polio vaccine.

Lab Tests: It is important that you attend all appointments with doctors and labs. Your doctor will likely order blood and urine tests regularly. These tests are necessary for the doctor to check you for side effects.

Sun-Protection: Your skin may burn more easily while taking this medication – it is therefore recommended that you use sunscreen and wear protective clothing to decrease the chances of this happening.

Side Effect Management:

Stomach: You will likely experience nausea and vomiting when taking this medication and will be given another medication to help prevent and stop this from happening. If this medication is not working, talk to you doctor or pharmacist as there are other medications available to prevent nausea and vomiting.

Children: Has been used. Lower doses are usually required. Discuss the risks/benefits with your doctor.

Seniors: Lower doses are usually required at the start of therapy due to the increase chances for side effects.

Pregnancy: Should be avoided if possible as this medication could cause harm to the baby. Discuss the risks with your doctor.

Women who are nursing: Not recommended. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know how this drug affects them personally.

Alcohol: If you drink, always drink in moderation.

Overdose: An overdose is unlikely as this drug is only administered under close medical supervision in the hospital.

Stopping the drug: If you have concerns about this medication, talk to your doctor before you make any decisions to stop using the drug.

If you miss a dose: Doxorubicin is administered in the hospital. If you miss an appointment, contact your doctor as soon as possible.

Storage conditions: Stored in the hospital.

Dietary precautions: None unless prescribed by your doctor.