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 powder for reconstitution, and is supplied in single- or multi-dose vials. The medication is administered by healthcare professionals in a clinical setting. The infusion is typically given over 3 to 10 minutes, or as a longer infusion depending on the regimen. For the liposomal form (as in Doxil), it is infused over at least 60 minutes. Doxorubicin should not be given as a rapid injection (bolus) or as an undiluted solution.

How it works

Doxorubicin is an anthracycline chemotherapy medicine. It works by interfering with the DNA inside cancer cells. Specifically, it binds to DNA and inhibits the enzymes needed for DNA and RNA synthesis, which are essential for cell growth and division. Doxorubicin also interacts with an enzyme called topoisomerase II, forming complexes that break DNA strands and prevent the cancer cell from repairing itself. This leads to cell death, especially in cells that are rapidly dividing, such as cancer cells.

Because it targets rapidly dividing cells, doxorubicin can also affect healthy cells that divide quickly, such as those in the bone marrow, digestive tract, and hair follicles. This is why some side effects, like low blood counts, mouth sores, and hair loss, are common.

Who Should take it

Doxorubicin is indicated for the treatment of various blood cancers, including large B-cell lymphoma (a type of non-Hodgkin lymphoma), Hodgkin lymphoma, acute lymphoblastic leukemia, and acute myeloblastic leukemia. It is also used in combination with other chemotherapy drugs for the treatment of other cancers, such as breast cancer, ovarian cancer, and soft tissue sarcomas.

For large B-cell lymphoma, doxorubicin is often part of combination chemotherapy regimens (such as CHOP: cyclophosphamide, doxorubicin, vincristine, and prednisone). Your doctor will determine if doxorubicin is appropriate for you based on your specific diagnosis, stage of disease, and overall health.

Who should not take it

You should not receive doxorubicin if you have:

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

Doxorubicin should also be avoided during the first trimester of pregnancy due to the risk of harm to the unborn baby. People with a history of severe reactions to similar drugs should not take it. Your healthcare team will evaluate your heart and liver function before starting treatment.

Commonly used with

Doxorubicin is most commonly used in combination with other chemotherapy drugs. For large B-cell lymphoma, it is a key part of the CHOP regimen, which includes cyclophosphamide, doxorubicin, vincristine, and prednisone. It may also be used with rituximab (R-CHOP) for certain types of lymphoma.

In other cancers, it may be combined with agents such as cyclophosphamide, methotrexate, fluorouracil, vincristine, and others, depending on the specific treatment protocol.

Commonly tested with

Doxorubicin is often tested in clinical trials with other chemotherapy agents, targeted therapies, and supportive care medications. In lymphoma, it is commonly tested with cyclophosphamide, vincristine, prednisone, and rituximab. Studies may also evaluate its use with newer targeted therapies or immunotherapies to improve outcomes or reduce side effects.