Doxorubicin (HCl)

Doxorubicin (HCl)/Adriamycin HCl is antineoplastic agent, also called as anticancerous drug. Doxorubicin (HCl) is the prototype agent of anthracycline antibiotic, isolated from Streptomyces peucetius var caesius. It contains an amino sugar and an anthracycline ring. Doxorubicin (HCl) is among the most useful cytotoxic anticancerous drugs. It has a broad spectrum of potent activity against many different types of cancers specially hematological malignancies. Doxorubicin (HCl) is used in combination with different anticancerous drugs to obtain best therapeutic effects and to reduce the side effects or toxicities.

Doxorubicin (HCl) is primarily indicated in conditions like A variety of solid tumors, Acute leukemia, Breast cancer, Hodgkin's disease, Kaposi's sarcoma, Leukemia, Lung cancer, Lymphomas, Metastatic breast cancer, Metastatic ovarian cancer, Multiple myeloma, estrogenic sarcoma, Soft tissue sarcoma.

Doxorubicin (HCl) is contraindicated in conditions like Cardiac arrhythmia, Active infection, Pregnancy, Breast feeding.

The severe or irreversible adverse effects of Doxorubicin (HCl), which give rise to further complications include Radio sensitization, Recall phenomenon. Doxorubicin (HCl) produces potentially life-threatening effects which include Bone marrow suppression, Cardiotoxicity, which are responsible for the discontinuation of Doxorubicin (HCl) therapy. The signs and symptoms that are produced after the acute over dosage of Doxorubicin (HCl) include Mucositis, Acute cardiac damage. The symptomatic adverse reactions produced by Doxorubicin (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Alopecia, Anorexia, Diarrhea, Urticaria, Oral ulceration, Esophagitis, Lacrimation, Conjunctivitis, Local hypothermia, Alopecia, Hyperpigmentation of nails.

Doxorubicin should be used with caution in patients who have had previous myelosuppressive therapy such as chemotherapy or radiation therapy, in patients with tumor infiltrate of the bone, with hepatic disease, in patients with dental disease. Dental work should be performed prior to initiating doxorubicin therapy, or deferred until blood counts return to normal. It should be used with extreme caution in patients with cardiac disease. Patients with active infection should be treated prior to receiving doxorubicin, the dose should be reduced or discontinued in patients who develop such infections. Patients should be observed closely for signs of cardiotoxicity; early recognition is essential for successful treatment of doxorubicin-induced cardiac toxicity. A reduction in dosage and/or dosage interval is indicated in patients with moderate to severe stomatitis. Doxorubicin therapy should not be initiated until patients recover normal hematopoiesis after bone marrow depression. Patients with pre-existing heart failure, with angina, or with cardiac arrhythmias are not good candidates to receive doxorubicin. It should not be administered during pregnancy and lactation.

Drug should not be given to Pregnant Mothers, Cardiac / Hypertensive Patients, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

60 to 75 mg/sq.meter (68 (67.5)) As recommended. IV — Every 3rd Week, or As Required

60 to 90 mg/sq.meter (75 (75)) As recommended. IV Infusion — Over 96 Hours, every 3-4 weeks

No neonatal dosage information is recorded for this medicine yet.

Doxorubicin (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementActinomycin DCyclophosphamideCyclophosphamideDigoxinDocetaxelHeparin (Na) and Heparin (Cl)Mercaptopurine (Monohydrate)Mercaptopurine (Monohydrate)MethotrexatePaclitaxelRiboflavin (Vitamin B2)Riboflavin may deactivate doxorubicin, a medication used for the treatment of certain cancers. In addition, doxorubicin may deplete levels of riboflavin in the body.Rotavirus vaccineThe administration of live, attenuated virus or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received Doxorubicin (HCl).MajorIn general, live virus or bacterial vaccines should not be used in patients receiving Doxorubicin (HCl).StavudineStreptozotocinThe toxicity may be increased if streptozotocin is given concurrentlyMajorStrontium-89 ChlorideThe concomitant use of bone marrow depressants and strontium-89 chloride may have additive myelosuppressive effects. ModeratePatients should be monitored for excessive bone marrow suppression during treatment with strontium-89 chloride. Dose reductions of the other bone marrow depressants may be necessary.SulfapyridineConcurrent use of sulfapyridine with bone marrow depressants may increase the leukopenic or thrombocytopenic effects of these medications.If concurrent use is required, close observation for myelotoxic effects should be considered.Technetium Tc-99m GluceptateBrain images may show increased activity due to chemotherapeutic neurotoxicity following therapy Doxorubicin (HCl) and Technetium Tc-99m Gluceptate.TrastuzumabValsartanVitamin EVORICONAZOLEVoriconazole may increase the serum concentration of doxorubicin by decreasing its metabolism Monitor for changes in the therapeutic and adverse effects of doxorubicin if voriconazole is initiated, discontinued or dose changed. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Inj (reconstituted soln) Store at room temperature, or in refrigerator. Protect from Sunlight. Use within 48 hrs if refrigerated and within 24 hrs if kept at room temperature.