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 powder that is mixed with a liquid before being administered. For standard doxorubicin, the infusion is typically given over 3 to 10 minutes, but it may also be given as a longer continuous infusion through a central line.

A special form called liposomal doxorubicin (as in Doxil) is also administered by IV infusion, but over a longer period (usually 60 minutes or more) and should not be given as a rapid injection or undiluted.

Doxorubicin is not available as a pill or oral medication.

How it works

Doxorubicin works by interfering with the DNA inside cancer cells. It is classified as an anthracycline and a topoisomerase II inhibitor. Doxorubicin enters the cancer cell and inserts itself between the DNA strands (a process called intercalation), which blocks the cell's ability to copy its DNA and divide. It also binds to cell membranes and forms complexes with an enzyme called topoisomerase II, which is essential for DNA repair and replication.

By disrupting these processes, doxorubicin causes cancer cells to die. However, it can also affect normal, healthy cells, especially those that divide quickly, which is why side effects can occur. The liposomal form (Doxil) is encapsulated in tiny fat-like particles (liposomes), which helps the drug stay in the bloodstream longer and may reduce some side effects by targeting the drug more directly to cancer cells.

Who should take it

Doxorubicin is used to treat a variety of cancers, including blood cancers such as non-Hodgkin lymphoma (which includes marginal zone lymphoma), Hodgkin lymphoma, and certain types of leukemia. It is often used as part of a combination chemotherapy regimen, meaning it is given with other cancer-fighting drugs.

For marginal zone lymphoma, doxorubicin may be included in multi-drug regimens, especially for more aggressive or advanced cases. Your doctor will determine if doxorubicin is right for you based on the type and stage of your cancer, your overall health, and your treatment goals.

Who should not take it

Doxorubicin should not be used in people who have had a recent heart attack, have severe heart problems (such as severe heart failure), or have had a severe allergic reaction to doxorubicin or any of its components. It is also not recommended for people with severe liver impairment or those with very low blood counts due to previous chemotherapy.

If you are pregnant, planning to become pregnant, or breastfeeding, you should not take doxorubicin, as it can harm the unborn baby or nursing infant. Always inform your doctor about your full medical history before starting treatment.

Commonly used with

Doxorubicin is commonly used with other chemotherapy drugs, depending on the type of cancer. For lymphomas, it is often part of the CHOP regimen (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone). In multiple myeloma, the liposomal form is used with bortezomib. It may also be combined with other agents such as rituximab for certain lymphomas.

Your doctor will choose the best combination based on your specific diagnosis.

Commonly tested with

Doxorubicin has been tested in combination with a variety of chemotherapy agents, including cyclophosphamide, vincristine, prednisone, methotrexate, fluorouracil, bortezomib (for multiple myeloma), and others. In clinical trials, different combinations are studied to find the most effective regimens with the fewest side effects for each type of cancer, including blood cancers like marginal zone lymphoma.