Liposomal Daunorubicin (Generic Name)

Other Names: DaunoXome

About This Drug

Liposomal daunorubicin is used to treat cancer. It is given intravenously (IV).

Possible Side Effects (More Common)

  • Lack of strength and energy
  • Nausea and vomiting
  • Headache 
  • Cough
  • Diarrhea (may last for several days)
  • Skin and tissue irritation. You may have redness, pain, warmth, or swelling at the IV site. This irritation occurs if the drug leaks out of the vein and into surrounding tissue.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. It may increase your risk of infection, fatigue, and bleeding.
  • Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.
    • Be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Effects on the heart. Your heart may be affected by high amounts of this drug. This can weaken the heart and decrease heart function. Your heart function will be checked as needed. You may also experience:
    • Difficulty catching your breath
    • Ankle swelling
    • Difficulty breathing when lying flat

Possible Side Effects (Less Common)

  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Usually hair loss is temporary; your hair should grow back when treatment is completed.
    Hair thinning is temporary. Your hair should grow back when treatment is completed.
  • Confusion, abnormal thinking
  • Depression
  • Trouble sleeping
  • Joint or muscle pain
  • Changes in your liver function. Your doctor will monitor your liver function as needed.
  • Eye irritation.  You may have watery eyes.  Your eyes and lids may become red and painful, and an infection could develop.
  • Vision changes
  • Earache, ringing in the ear, or deafness

Sexual Problems and Reproductive Concerns

In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.

Pregnancy Warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment. Speak with your doctor or nurse about effective methods of birth control.

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.

Breast Feeding Warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.

Women may experience signs of menopause like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during intercourse.

Treating Side Effects

  • Mouth care is very important. Your mouth care should consist of gently brushing your teeth with a very soft toothbrush and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. 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.
  • Ask your doctor or nurse about medication to help prevent or lessen nausea and vomiting.
  • Speak with your nurse about obtaining 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 undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and  skin and nail care.
  • Do not put anything on your rash unless you ask your doctor or nurse. Keep the area around the rash clean and dry.
  • Be careful to avoid injury when you’re cooking, walking, and handling sharp objects and hot liquids.
  • To help prevent or lessen skin reactions, for at least three days after you receive this drug:
    • Do not use tape on your skin
    • Do not wear tight clothing or jewelry
    • Do not bathe in very hot water
    • Do not put pressure on your joints or bony areas
    • Do not do activities that cause pressure or friction on the skin
    • Do not go outdoors without protection from the sun

Food and Drug Interactions

There are no known interactions of liposomal daunorubicin with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

Allergic Reactions

Serious allergic reactions including anaphylaxis may occur during the time you are receiving this drug by IV. Tell your doctor or nurse immediately if you have any of the following symptoms:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Rash and/or itching

Infusion Reactions

Most people who have this kind or reaction experience it during the first infusion, but a small percent could experience it after the first infusion. Symptoms of an infusion reaction may include:

  • Flushing
  • Shortness of breath
  • Facial swelling
  • Headache
  • Chills
  • Back pain
  • Tightness in the chest or throat
  • Low blood pressure (lightheadedness)

It is important to tell your nurse right away if you experience any of these symptoms. These reactions will be closely monitored by your nurse. The drug infusion may be slowed down or stopped. The reactions end within several hours to a day after the infusion is stopped.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or higher
  • Chills
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than three times in one day
  • Ankle swelling
  • Difficulty catching your breath
  • Dizziness
  • Difficulty breathing when lying flat

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Pain in mouth or throat that makes it difficult to eat or drink
  • Diarrhea of five to six stools in one day or diarrhea with weakness or lightheadedness
  • Nausea unrelieved by prescribed medication
  • Painful skin areas, blisters, or peeling
  • Swelling of your hands or feet
  • Headache unrelieved by prescribed medication
  • Difficulty walking or changes in the way you walk
  • Extreme fatigue that interferes with normal activities
  • Rash that is bothersome
  • Muscle weakness

Revised November 2011

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