Common brand names

• Adriamycin
• Doxil

How it is administered

Doxorubicin is given by intravenous (IV) infusion, meaning it is delivered directly into a vein. It is available as a solution or powder that is mixed with a liquid before being administered. The medication is usually given in cycles, with each cycle followed by a rest period to allow your body to recover. The exact dosing schedule and amount depend on the type of cancer, your overall health, and other medications you may be receiving.

There are also liposomal forms of doxorubicin (such as Doxil), which are specially formulated to stay in the bloodstream longer and may be used in certain situations. These are also given by IV infusion.

How it works

Doxorubicin is a type of chemotherapy known as an anthracycline. It works by interfering with the DNA inside cancer cells, preventing them from growing and dividing. Specifically, doxorubicin binds to DNA and inhibits the activity of enzymes called topoisomerases, which are necessary for DNA replication and repair. This leads to breaks in the DNA strands, ultimately causing the cancer cells to die.

In addition to its effects on DNA, doxorubicin can also generate free radicals, which are highly reactive molecules that can damage cell membranes and other cellular components. While these actions are effective at killing cancer cells, they can also affect normal, healthy cells, leading to side effects.

Who should take it

Doxorubicin is used to treat a variety of cancers, including blood cancers such as non-Hodgkin lymphoma (which includes follicular lymphoma), Hodgkin lymphoma, and certain types of leukemia. It is also used for other cancers like breast cancer, ovarian cancer, and sarcomas.

For follicular lymphoma and other non-Hodgkin lymphomas, doxorubicin is often part of combination chemotherapy regimens. 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

Doxorubicin should not be used in patients with severe heart problems, such as severe myocardial insufficiency or recent heart attack, as it can cause further heart damage. It is also contraindicated in people with severe persistent drug-induced myelosuppression (very low blood counts from previous chemotherapy), severe liver impairment, or those who have had a severe allergic reaction to doxorubicin or its components.

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.

Commonly used with

Doxorubicin is often used in combination with other chemotherapy drugs for blood cancers. For follicular lymphoma and other non-Hodgkin lymphomas, it is commonly part of the R-CHOP regimen, which includes rituximab, cyclophosphamide, vincristine, and prednisone.

In other cancers, it may be combined with drugs such as cyclophosphamide, methotrexate, fluorouracil, or bortezomib (especially in multiple myeloma).

Commonly tested with

Doxorubicin has been tested in combination with many other chemotherapy agents, including cyclophosphamide, vincristine, prednisone, rituximab, methotrexate, fluorouracil, and bortezomib. These combinations are used to improve treatment outcomes for various cancers, including blood cancers like follicular lymphoma.