Common brand names

• Adriamycin
• Doxil

How it is administered

Doxorubicin is given by intravenous (IV) infusion, meaning it is injected directly into a vein. It is available as a solution or as a powder that is mixed with a liquid before use. Doxorubicin is typically administered in a hospital or clinic setting by a healthcare professional. The medication is infused over several minutes to an hour, depending on the specific treatment plan. There are also liposomal formulations (such as Doxil) that are administered in a similar way but are encapsulated in tiny fat-like particles to help reduce some side effects.

How it works

Doxorubicin is a type of chemotherapy known as an anthracycline topoisomerase inhibitor. It works by entering cancer cells and binding to their DNA. This binding interferes with the cell’s ability to replicate and repair its DNA, which is essential for cell growth and division. Doxorubicin also interacts with an enzyme called topoisomerase II, which is involved in DNA replication. By disrupting these processes, doxorubicin causes cancer cells to die.

The medication also generates free radicals, which can damage cell membranes and other parts of the cell, further contributing to its anti-cancer effects. However, these actions can also affect healthy cells, especially those that divide quickly, such as cells in the bone marrow, digestive tract, and hair follicles. This is why doxorubicin can cause side effects like low blood counts, mouth sores, and hair loss.

Who should take it

Doxorubicin is used to treat a variety of cancers, including certain blood cancers like acute lymphoblastic leukemia, acute myeloblastic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma. It is also used for solid tumors such as breast cancer, ovarian cancer, and others. For blood cancers, doxorubicin is often part of a combination chemotherapy regimen.

For Adult T-cell Leukemia/Lymphoma (ATLL), doxorubicin may be included as part of multi-drug chemotherapy protocols, especially in aggressive or advanced cases. Your doctor will determine if doxorubicin is appropriate for you based on your specific diagnosis, overall health, and other treatments you may be receiving.

Who should not take it

Doxorubicin should not be used by people who have had a recent heart attack, have severe heart problems, or have severe persistent low blood counts from previous chemotherapy. It is also not recommended for those with severe liver impairment or those who have had a severe allergic reaction to doxorubicin or similar drugs.

Women who are pregnant should not receive doxorubicin, as it can harm the unborn baby. Breastfeeding is also not recommended during treatment and for a period after the last dose. If you have any of these conditions or concerns, discuss them with your healthcare provider before starting treatment.

Commonly used with

Doxorubicin is frequently used in combination with other chemotherapy drugs to increase its effectiveness. For blood cancers, it is often combined with medications such as cyclophosphamide, vincristine, and prednisone (the CHOP regimen for lymphoma), or with other agents depending on the specific type of leukemia or lymphoma being treated.

The combination is chosen based on the type of cancer, its stage, and individual patient factors.

Commonly tested with

Doxorubicin has been tested in clinical trials with a variety of other chemotherapy agents, including cyclophosphamide, vincristine, methotrexate, fluorouracil, and bortezomib (for multiple myeloma). It has also been studied in combination with newer targeted therapies and supportive medications to reduce side effects, such as dexrazoxane for heart protection.

Your treatment plan will be tailored to your specific needs and may involve several medications used together to achieve the best possible outcome.