Doxorubicin (patient information)

# IMPORTANT WARNING
Doxorubicin can cause a decrease in the number of blood cells in your bone marrow. Prolonged use of doxorubicin can also cause severe heart damage, even years after you have stopped taking doxorubicin. The risk of heart damage after stopping doxorubicin is higher in children.
Tell your doctor if you have ever had chemotherapy with daunorubicin (Cerubidine, DaunoXome), doxorubicin, idarubicin (Idamycin), or radiation therapy to the chest and if you have or have had heart or liver disease. Tell your doctor if you are taking cyclophosphamide (Cytoxan, Neosar) or mitoxantrone (Novantrone).
If you experience any of the following symptoms, call your doctor immediately: back pain, flushing, or chest tightness. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to doxorubicin.
When doxorubicin is administered into a vein, it may leak into surrounding tissue. Your doctor or health care provider will monitor your administration site for this reaction.
Talk to your doctor about the risks of taking doxorubicin.

# About your treatment
Your doctor has ordered the drug doxorubicin to help treat your illness. The drug is given by injection into a vein.
This medication is used to treat:
- breast cancer
- ovarian cancer
- transitional cell bladder cancer
- bronchogenic lung cancer
- thyroid cancer
- gastric cancer
- soft tissue and osteogenic sarcomas
- neuroblastoma
- Wilms' tumor
- malignant lymphoma (Hodgkin's and non-Hodgkin's)
- acute myeloblastic leukemia
- acute lymphoblastic leukemia
- Kaposi's sarcoma related to acquired immunodeficiency syndrome (AIDS)
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Doxorubicin is a type of antibiotic that is only used in cancer chemotherapy. It slows or stops the growth of cancer cells in your body. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

# Other uses for this medicine
Doxorubicin is also used to treat Ewing's tumor; squamous cell carcinomas of the head, neck, cervix, and vagina; carcinomas of the testes, prostate, and uterus; and refractory multiple myeloma. Talk to your doctor about the possible risks of using this drug for your condition.

# Precautions
Before taking doxorubicin:
- tell your doctor and pharmacist if you are allergic to doxorubicin or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially those listed in the IMPORTANT WARNING section, actinomycin D (Cosmegen), aspirin, cyclosporine (Neoral, Sandimmune), paclitaxel (Taxol), phenobarbitol (Barbital), phenytoin (Dilantin), progesterone injection, verapamil (Calan, Covera, Verelan), streptozocin (Zanosar), and vitamins.
- in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had kidney disease.
- you should know that doxorubicin may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Doxorubicin may harm the fetus.
- do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

# Side effects

## Minor side effects
Side effects from doxorubicin are common and include:
- nausea and vomiting which may last up to 24-48 hours after treatment
- loss of appetite
- diarrhea
- difficulty swallowing
- thinned or brittle hair
- skin irritation (sunburn-like) or rash on areas previously exposed to radiation treatments
- darkening of fingernails or toenails
- swelling, pain, redness, or peeling of skin on the palms and soles of the feet
Tell your doctor if either of these symptoms is severe or lasts for several hours:
- fatigue
- mouth blistering

## Severe side effects
If you experience any of the following symptoms or those listed in the IMPORTANT WARNINGS section, call your doctor immediately:
- unusual bruising or bleeding
- red urine or sweat
- pain at the injection site
- persistent diarrhea or any change in normal bowel habits for more than 2 days
- fever
- chills
- sore throat
- breathing discomfort
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Brand names
- Adriamycin PFS
- Adriamycin RDF
- Adriamycin
- Doxil
- Rubex

# Other names
- Hydroxydaunomycin
- Hydroxydoxorubicin
- Liposomal doxorubicin