Doxorubicin-Liposomal

Doxorubicin liposomal is a prescription medication used for the treatment of Kaposi sarcoma, ovarian cancer, and multiple myeloma. 

• Doxorubicin liposomal is available under the following different brand names: Doxil, Lipodox, Myocet

Common side effects of Doxorubicin liposomal include:

• low blood cell counts,
• fever,
• feeling weak or tired,
• loss of appetite,
• nausea,
• vomiting,
• constipation,
• diarrhea,
• hand-foot syndrome (pain, redness, numbness, and peeling skin on the hands or feet),
• rash, and
• hair loss.

Serious side effects of Doxorubicin liposomal include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• fever,
• chills,
• lightheadedness,
• shortness of breath,
• itching,
• warmth,
• tingling,
• headache,
• pain or tightness in the chest,
• back pain,
• fast heartbeats,
• blue-colored skin, lips, or nails,
• blisters or ulcers in the mouth,
• red or swollen gums,
• trouble swallowing,
• pain, redness, numbness, and peeling skin on the hands or feet,
• tiredness,
• skin sores,
• easy bruising or unusual bleeding,
• pale skin,
• cold hands and feet,
• fast heartbeats, and
• swelling in the ankles or feet.

Rare side effects of Doxorubicin liposomal include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Injectable solution

• 2 mg/ mL

Kaposi Sarcoma

Adult dosage

• 20 mg /m² IV every 3 weeks

Ovarian Cancer

Adult dosage

• 50 mg /m² IV every 4 weeks for 4 courses minimum

Multiple myeloma

Adult dosage

• 30 mg /m² IV on day 4 following bortezomib 1.3 mg/m² on days 1, 4, 8 & 11 every 3 weeks

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Doxorubicin liposomal has severe interactions with no other drugs.
• Doxorubicin liposomal has serious interactions with at least 27 other drugs.
• Doxorubicin liposomal has moderate interactions with at least 121 other drugs.
• Doxorubicin liposomal has minor interactions with the following drugs:
  • armodafinil
  • artemether/lumefantrine
  • dactinomycin
  • deferasirox
  • hydrocortisone
  • progesterone, natural
  • quinupristin/dalfopristin
  • rifapentine
  • ruxolitinib
  • ruxolitinib topical

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• History of severe hypersensitivity to doxorubicin, including anaphylaxis

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Doxorubicin liposomal?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Doxorubicin liposomal?”

Cautions

• Serious and sometimes life-threatening infusion-related reactions are reported; ensure that medications to treat infusion-related reactions and cardiopulmonary resuscitative equipment are available for immediate use prior to initiation (see Black Box Warnings)
• Incidence of hand-foot syndrome in 1 trial was 51%, including 24% grade 3 or 4 toxicity (see Dosage Modifications)
• Secondary oral cancers, primarily squamous cell carcinoma, have been reported
• Based on animal data, can cause fetal harm when administered to pregnant women
• Cardiomyopathy
  • Can result in myocardial damage, including acute left ventricular failure; the risk of cardiomyopathy is generally proportional to the cumulative exposure (see Black Box Warnings)
  • Include prior use of other anthracyclines or anthracenediones in calculations of cumulative dose; the risk of cardiomyopathy may be increased at lower cumulative doses in patients with prior mediastinal irradiation
  • Assess left ventricular cardiac function (e.g. MUGA or echocardiogram) prior to initiation of therapy, during treatment to detect acute changes, and after treatment to detect delayed cardiomyopathy
  • Administer therapy to patients with a history of cardiovascular disease only when the potential benefit of treatment outweighs the risk
• Infusion reactions
  • Ensure that medications to treat infusion-related reactions and cardiopulmonary resuscitative equipment are available for immediate use prior to initiation of treatment
  • Initiate infusions at a rate of 1 mg/min and increase the rate as tolerated
  • Withhold therapy for Grade 1, 2, or 3 infusion-related reactions and resume at a reduced infusion rate
  • Discontinue therapy for serious or life-threatening infusion-related reactions

Pregnancy & Lactation

• Based on findings in animals and its mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; avoid use during the 1st trimester
• Verify the pregnancy status of females of reproductive potential prior to initiating therapy
• Contraception
  • Females
    • Advise females of reproductive potential to use effective contraception during and for 6 months after treatment
  • Males
    • Therapy may damage spermatozoa and testicular tissue, resulting in possible genetic fetal abnormalities; males with female sexual partners of reproductive potential should use effective contraception during and for 6 months after treatment
• Infertility
  • In females of reproductive potential, therapy may cause infertility and result in amenorrhea; premature menopause can occur; recovery of menses and ovulation is related to age at treatment
  • In males drug may result in oligospermia, azoospermia, and permanent loss of fertility; sperm counts have been reported to return to normal levels in some men; this may occur several years after the end of therapy
• Lactation
  • Not known whether the drug is present in human milk; because many drugs, including anthracyclines, are excreted in human milk and because of the potential for serious adverse reactions in breastfed infants from therapy, discontinue breastfeeding during treatment