Drug information of Doxorubicin

Doxorubicin

Drug group:

Doxorubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body. Doxorubicin is used to treat different types of cancers that affect the breast, bladder, ovary, thyroid, stomach, lungs, bones, nerve tissues, muscles, joints, and soft tissues. Doxorubicin is also used to treat Hodgkin's disease and certain types of leukemia.

Mechanism of effect

The mechanism of action of doxorubicin HCl is thought to be related to its ability to bind DNA and inhibit nucleic acid synthesis. Cell structure studies have demonstrated rapid cell penetration and perinuclear chromatin binding, rapid inhibition of mitotic activity and nucleic acid synthesis, and induction of mutagenesis and chromosomal aberrations.

Pharmacodynamic

Doxorubicin is an antineoplastic in the anthracycline class. Doxorubicin is used to produce regression in disseminated neoplastic conditions.

Pharmacokinetics

The distributive half-life is 5 minutes, which suggests that doxorubicin is rapidly taken up by tissue. Doxorubicin and its major metabolite, doxorubicinol, is 74-76% bound to plasma protein. Doxorubicin is capable of undergoing 3 metabolic routes.40% of the dose appears in bile in 5 days. 5-12% of the drug and its metabolites appears in urine during the same time period. <3% of the dose recovered in urine was doxorubicinol.

Dosage

Usual Adult Dose for Ovarian Cancer
When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.
Usual Pediatric Dose for Malignant Disease
35 to 75 mg/m2 as a single dose repeated every 21 days, or 20 to 30 mg/m2 once weekly, or 60 to 90 mg/m2 given as a continuous infusion over 96 hours every 3 to 4 weeks.

Alerts

1-Doxorubicin HCl can result in myocardial damage, including acute left ventricular failure. The risk of cardiomyopathy with doxorubicin HCl is generally proportional to the cumulative exposure. The relationship between cumulative Doxorubicin dose and the risk of cardiac toxicity has not been determined.
2-Ensure that medications to treat infusion-related reactions and cardiopulmonary resuscitative equipment are available for immediate use prior to initiation of Doxorubicin.

Points of recommendation

1- Advise patients to contact their healthcare provider if they develop symptoms of heart failure
2- Inform patients that following Doxorubicin administration, a reddish-orange color to the urine and other body fluids may be observed. This nontoxic reaction is due to the color of the product and will dissipate as the drug is eliminated from the body.

Pregnancy level

D


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