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How it is administered
Doxorubicin is given as an intravenous (IV) infusion, meaning it is delivered directly into a vein. It is available as a solution or as a powder that is mixed with a liquid before use. The medication is usually administered in a hospital or clinic setting by a healthcare professional.
There are different formulations, including standard doxorubicin and a liposomal form (which helps the drug stay in the bloodstream longer and target cancer cells more effectively). The dose and schedule depend on the type of cancer being treated, other medications being used, and your overall health.
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. Specifically, doxorubicin intercalates (inserts itself) into DNA strands and inhibits the action of enzymes called topoisomerases, which are needed for DNA replication and repair.
By blocking these critical processes, doxorubicin causes cancer cells to die. It also binds to cell membranes and proteins, which can contribute to its effects. While doxorubicin is effective at killing rapidly dividing cancer cells, it can also affect healthy cells, which leads to some of its side effects.
Common side effects
- Hair loss (alopecia)
- Nausea and vomiting
- Low white blood cell counts (increasing infection risk)
- Low platelet counts (increasing bleeding risk)
- Mouth sores (stomatitis)
- Red or orange discoloration of urine for a few days after treatment
- Fatigue
- Loss of appetite
Other possible side effects include diarrhea, skin changes, and, rarely, heart problems (such as heart failure or arrhythmias), especially with higher cumulative doses.
Who Should take it
Doxorubicin is used to treat a variety of cancers, including several blood cancers such as Hodgkin lymphoma and non-Hodgkin lymphoma, as well as acute lymphoblastic leukemia and acute myeloblastic leukemia. It is also used for other cancers like breast cancer, ovarian cancer, and soft tissue sarcomas.
For blood cancers, doxorubicin is often given as part of a combination chemotherapy regimen. It may be considered for patients whose disease is aggressive or has not responded to other treatments. The decision to use doxorubicin depends on your specific diagnosis, overall health, and previous treatments.
Who should not take it
You should not receive doxorubicin if you have severe heart problems (such as recent heart attack or severe heart failure), severe liver disease, or severe ongoing bone marrow suppression from previous chemotherapy. It is also contraindicated if you have had a serious allergic reaction to doxorubicin or its components.
Doxorubicin can cause harm to unborn babies, so it should not be used during pregnancy unless absolutely necessary. Women who are breastfeeding should not use doxorubicin, as it can pass into breast milk and harm the baby.
Commonly used with
Doxorubicin is often used in combination with other chemotherapy drugs to increase its effectiveness. For blood cancers, it may be combined with medications such as cyclophosphamide, vincristine, prednisone, and others, depending on the specific type of cancer and treatment protocol.
In multiple myeloma, the liposomal form of doxorubicin may be used with bortezomib. Your doctor will determine the best combination based on your diagnosis.
Commonly tested with
Doxorubicin has been tested in clinical trials with a variety of other chemotherapy agents, including cyclophosphamide, methotrexate, fluorouracil, vincristine, and bortezomib, among others. These combinations are designed to target cancer cells in different ways and improve treatment outcomes.
Your healthcare team will monitor your response to treatment and may adjust your regimen based on how you tolerate the medications.