Doxorubicin HCL (adriamycin)

Indications & Dose:

Acute granulocytic leukaemia, Wilms’ tumour, neuroblastoma, sarcomas, breast carcinoma, ovarian carcinoma, hepatoma, bladder Ca, thyroid Ca, bronchogenic Ca (non oat cell), Hodgkin’s & non Hodgkin’s lymphomas. GI tract carcinoma. Acute myeloblastic leukaemia, bronchogenic, breast and ovarian carcinoma, soft tissue and bone sarcomas, Malignant lymphoma. Primary management of nonmetastatic bladder carcinoma (intravesical administration). Wilm’s tumor. Neuroblastoma.

DOSE

For i/v use only and avoid extravasation of drug.

Adult

60-75 mg/m2 as a single inj administered at 21 days interval max. upto 500 mg/m2. Combination therapy: Therapy 40-60mg /square meter IV every 21-28 days.

Children

30 mg/m2 i/v as each of 3 succe-ssive days repeated every 4 weeks.
Administration : IV administer push over 1-2 minutes or IVP Bolus . Infusion via CV line recommended. Reconstitute lypholized poweder with NS to a final concentration of 2mg/ml as follows. Further dilution is Dextrose Water or Normal salineis stable for 48 hours at room temprature 25Degtee centigrade when protacted from light. Unstable in solutions with a PH <3 or >7 Standard IV dilution : IVP dose /syringe ( concentration : 20mg/ml) IVP Bolus: 50-100ml D5W or NS

Contraindications:

Severe CCF, cardiomyopathy, myelosuppression, malignant myeloma, kidney Ca, large bowel Ca, brain tumours. Buccal ulceration, bone marrow depression.
Pregnancy & breast-feeding. 

Side Effects:

Nausea, vomiting, diarrhea, fever, red urine (harmless), ventricular arrhythmia, severe local tissue damage on extravasation, cardiotoxicity, bone marrow depression, anorexia, stomatitis, alopecia, conjunctivitis

Cautions:

Skin hypersensitivity, oesophagitis, pneumonitis or gastritis, severe myelosuppression may occur, local tissue necrosis, hyperuricemia.

Precautions:

Cardiac or hepatic dysfunction. Haematological and cardiac monitoring, children, infection.,
Old age: May be used in reduced dose.

Interaction:

Drugs
Macraptopurine: Hepatotoxicity of mercaptopurine enhanced leading to cholesta

Cyclophosphamide: Exacerbation of cyclophosphamide induced haemorrhagic cystitis.

Barbiturates: Increase the plasma clearance of doxorubicin
Digoxin: Decreased serum levels of digoxin.
Streptozotocin: Increases toxicity of doxorubicin.
Radiation: Radiation induced toxicity to myocardium, mucosa, skin and liver increased.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: