Doxorubicin (Generic Name)

Other Names: Adriamycin®, hydroxyl daunorubicin
 

About this drug

Doxorubicin is a drug used to treat cancer. This drug is given in the vein (IV).

Possible side effects (more common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Hair loss: Hair loss is often complete scalp hair loss and can involve loss of eyebrows, eyelashes, and pubic hair. You may notice this a few days or weeks after treatment has started. Most often hair loss is temporary; your hair should grow back when treatment is done.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Change in the color of your urine to pink or red. This color change will go away in one to two days.
  • Effects on the heart: This drug can weaken the heart and lower heart function. Your heart function will be checked as needed. You may have trouble catching your breath, mainly during activities. You may also have trouble breathing while lying down, and have swelling in your ankles.
  • Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to the effects of the sun, sun lamps, and tanning beds. Your eyes may water more, mostly in bright light.
  • Metallic taste in the mouth: This may change the taste of food and drinks
  • Decreased appetite (decreased hunger)
  • Darkening of the skin or nails
  • Weakness that interferes with your daily activities

Possible side effects (less common)

  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
  • Changes in your liver function.  Your doctor will check your liver function as needed.
  • This drug may cause an increased risk of developing a second cancer

Allergic reaction

Serious allergic reactions, including anaphylaxis are rare.  While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly  or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash, and/or hives

Treating side effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid). 
  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, throwing up, and/or loose bowel movements
  • Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Talk with your nurse about getting a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • While you are getting this drug, please tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion.

Food and drug interactions

There are no known interactions of doxorubicin with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

 

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin,
  • During the IV infusion, if you have pain, redness, or swelling at the site of the IV infusion, please tell your nurse right away

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Decreased urine
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea and throwing up that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Extreme weakness that interferes with normal activities

Sexual problems and reproduction concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking. 
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning:  This drug may have harmful effects on the unborn baby, so effective methods of birth control should be used by you and your partner during your cancer treatment and for at least 6 months after treatment
  • Breast feeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and badly harm a breast feeding baby.

 

Revised July 2014

 

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