Doxorubicin Hydrochloride

Generic Details

Generic Name

doxorubicin-hydrochloride

Other Names

  • Adriamycin

Drug Class

  • Anti-neoplastic agent
  • Anthracycline

Chemical Formula

C27H29NO11.HCl

Molecular Weight

579.98 g/mol

Mechanism of Action

  • Inhibits topoisomerase II enzyme which is involved in DNA replication and repair
  • Forms DNA-topoisomerase II complex, leading to DNA damage and cell death

Indications

  • Breast cancer
  • Lung cancer
  • Ovarian cancer
  • Bladder cancer
  • Soft tissue sarcomas
  • Hodgkin's and Non-Hodgkin's lymphoma

Common Dosage Forms

  • Injection

Typical Dosage

  • 60-75 mg/m2 every 21 days for various cancers

Pediatric Dosage

  • Safety and efficacy not established for pediatric use

Geriatric Dosage

  • Dose adjustments may be needed in elderly patients due to decreased renal function

Side Effects

  • Nausea and vomiting
  • Myelosuppression (low blood cell counts)
  • Cardiotoxicity
  • Alopecia
  • Mucositis
  • Hand-foot syndrome

Contraindications

  • Severe myelosuppression
  • Severe cardiac insufficiency
  • Severe hepatic impairment

Pregnancy Category

  • D - Positive evidence of risk

Lactation Safety

  • Contraindicated during breastfeeding

Drug Interactions

  • Live vaccines (may be less effective)
  • Cyclophosphamide (increased risk of cardiotoxicity)

Overdose Symptoms

  • Severe myelosuppression
  • Mucositis
  • Alopecia
  • Gastrointestinal toxicity

Antidote for Overdose

  • No specific antidote, manage symptoms and provide supportive care

Storage Conditions

  • Store at 20-25°C (68-77°F), excursions permitted between 15-30°C (59-86°F)

Pharmacokinetics

  • Absorption: Intravenously administered
  • Distribution: Widely distributed in tissues including the heart, liver, and lungs
  • Metabolism: Primarily in the liver
  • Excretion: Mainly through biliary excretion and elimination in feces

Precautions

  • Monitor cardiac function regularly
  • Monitor blood counts before each dose
  • Avoid contact with skin or mucous membranes
  • Use adequate contraception during treatment

Warnings

  • Cardiotoxicity risk increases with cumulative doses
  • Extravasation can cause tissue damage and necrosis

Others

  • It is a vesicant – administer with caution to avoid extravasation