Common brand names

• Adriamycin
• Doxil

How it is administered

Doxorubicin is given as an intravenous (IV) infusion, meaning it is administered directly into your vein. It is available as a solution or powder that is mixed with a liquid before use. The medication is given in cycles, with the dose and schedule depending on your specific cancer type and treatment plan. For standard doxorubicin, the infusion usually takes 3 to 10 minutes, but in some cases, it may be given as a longer infusion through a central line. For the liposomal form (Doxil), the infusion is administered over at least 60 minutes to reduce the risk of infusion reactions.

Doxorubicin should only be administered by healthcare professionals experienced in cancer chemotherapy.

How it works

Doxorubicin is a type of chemotherapy known as an anthracycline topoisomerase inhibitor. It works by interfering with the DNA inside cancer cells, preventing them from growing and dividing. Doxorubicin inserts itself between the DNA strands (a process called intercalation), which blocks the enzymes needed for DNA replication and RNA production. This action damages the cancer cell's genetic material, leading to cell death.

Additionally, doxorubicin interacts with an enzyme called topoisomerase II, forming complexes that further break DNA strands. This dual action makes it effective against rapidly dividing cancer cells, which is why it is used to treat various blood cancers and solid tumors.

Who should take it

Doxorubicin is used to treat several types of cancer, including many blood cancers. It is indicated for:

• Acute lymphoblastic leukemia (ALL)
• Acute myeloblastic leukemia (AML)
• Hodgkin lymphoma
• Non-Hodgkin lymphoma

It is also used for other cancers such as metastatic breast cancer, soft tissue sarcomas, and more. For blood cancers, doxorubicin is often part of a combination chemotherapy regimen. Your doctor will determine if doxorubicin is appropriate for you based on your diagnosis, overall health, and previous treatments.

For rare blood cancers like Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN), doxorubicin may be considered as part of combination regimens, though it is not specifically approved for BPDCN.

Who should not take it

You should not take doxorubicin if you have:

• Severe heart problems (such as recent heart attack or severe heart failure)
• Severe persistent low blood counts due to previous chemotherapy
• Severe liver impairment (very high bilirubin levels or Child-Pugh Class C)
• Known severe allergic reaction to doxorubicin or its components

Doxorubicin should be used with caution in people with a history of heart disease, those who have had prior radiation to the chest, or those who are pregnant or breastfeeding. Always inform your doctor about your medical history before starting treatment.

Commonly used with

Doxorubicin is commonly used in combination with other chemotherapy drugs to increase effectiveness. For blood cancers, it may be combined with:

• Cyclophosphamide
• Vincristine
• Prednisone
• Cytarabine
• Methotrexate

In multiple myeloma, the liposomal form (Doxil) is often used with bortezomib. Your treatment plan will be tailored to your specific cancer type and health needs.

Commonly tested with

Doxorubicin has been tested in clinical trials with many other chemotherapy agents, including:

• Cyclophosphamide, methotrexate, and fluorouracil (CMF regimen)
• Vincristine, prednisone, and other agents in lymphoma regimens
• Bortezomib in multiple myeloma (especially with the liposomal form)

It is also studied with supportive medications to reduce side effects, such as dexrazoxane (to help protect the heart) and growth factors (to support blood counts).