Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. doxorubicin (adriamycin) STUDY. Do not start any new medicine before you talk with the doctor that prescribed Doxorubicin. Infections can sometimes be life threatening. Its mode of action is not yet understood; however, it has been postulated that it intercalates mainly within CG–GC base pairs in the minor grove of dsDNA. 90% or more of the drug remains encapsulated within the liposome during circulation.Doxorubicin has a small steady state and, therefore, is mainly limited to vascular fluid. Irreversible amenorrhea or early menopause. Adriamycin (DOXOrubicin HCl) Injection, USP and Adriamycin (DOXOrubicin HCl) for Injection, USP is indicated as a component of multi-agent adjuvant chemotherapy for treatment of women with axillary lymph node involvement following resection of primary breast cancer [see Clinical Studies (14.1)]. We know it’s a worrying time for people with cancer, we have information to help. Call your doctor if you have severe symptoms that prevent you from eating or drinking, such as. Each 2 mg/mL, 10 mL (20 mg) vial contains 20 mg Doxorubicin Hydrochloride, USP; Sodium Chloride 0.9% (to adjust tonicity) and Water for Injection q.s. You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme. Adriamycin (Doxorubicin HCl Injection, USP), Thalomid, Ninlaro, Kyprolis, Farydak, prednisone, methotrexate, dexamethasone, Arimidex, Keytruda, Armour Thyroid. Doxorubicin is a cytotoxic anthracycline antibiotic isolated from cultures of Streptomyces peucetius var.caesius. Include prior doses of other anthracyclines or anthracenediones in calculations of total cumulative dosage for doxorubicin. Following administration of doses ranging from 10 to 75 mg/m2 of doxorubicin to 60 children and adolescents ranging from 2 months to 20 years of age, doxorubicin clearance averaged 1443 ± 114 mL/min/m2. 6,8,11-trihydroxy-1-methoxy-5,12-naphthacenedione hydrochloride. It's typically used: Skin damage near the vein where Doxorubicin is given (Injection site reaction). Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Doxorubicin is indicated for the treatment of. 1963; DiMarco et al., 1964b).While weakly active against some microorganisms, the drug inhibits the multiplication of bacterial and animal viruses and exhibits a high cytotoxic activity against normal and neoplastic cells (Di Marco et al., 1964a). You may report side effects to FDA at 1-800-FDA-1088. Contact your advice line as soon as possible if: Early treatment can help manage side effects better. Sperm counts have been reported to return to normal levels in some men. You may have nosebleeds or bleeding gums after brushing your teeth. You may also have tingling, numbness, pain and dryness. SCC-15 cells (ATCC ® CRL-1623) were cultured in vitro.The close concentration of the median lethal dose (LD50) of ADM was 0.05 mg/l and the LD50 of MET was 10 mmol/l after 48 h of intervention. View Adriamycin CS mechanism of action for pharmacodynamics and pharmacokinetics details. Decrease the rate of doxorubicin administration if erythematous streaking along the vein proximal to the site of infusion or facial flushing occur. How often and how severe the side effects are can vary from person to person. The cytotoxic effect of doxorubicin on malignant cells and its toxic effects on various organs are thought to be related to nucleotide base intercalation and cell membrane lipid binding activities of doxorubicin. And women might be able to store eggs or ovarian tissue. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time. Ask your doctor or pharmacist how long you should avoid live vaccinations. Call freephone 9 to 5 Monday to Friday or email us. Mechanism : The cytotoxic effect of doxorubicin on malignant cells are thought to be related to nucleotide base intercalation and cell membrane lipid binding activities of doxorubicin. 2. It slows or stops the growth of cancer cells by blocking an enzyme called topo isomerase 2. Radiation recall, including but not limited to cutaneous and pulmonary toxicity, can occur in patients who receive doxorubicin after prior radiation therapy. ; pH adjusted to 3 using Hydrochloric Acid. The interaction of doxorubicin with topoisomerase II to form DNA-cleavable complexes appears to be an important mechanism of doxorubicin cytocidal activity. These free radicals area believed to be the primary cause of cardiotoxicity that typically becomes symptomatic years after therapy is completed. Concurrent use of trastuzumab and doxorubicin results in an increased risk of cardiac dysfunction. The clinical efficacy of doxorubicin containing regimens for the post-operative, adjuvant treatment of surgically resected breast cancer was evaluated in a meta-analysis conducted by the Early Breast Cancer Trialists Collaborative Group (EBCTCG). When doxorubicin is administered every 21 days, the neutrophil count reaches its nadir 10 to 14 days after administration with recovery usually occurring by the 21st day. Intercalation inhibits nucleotide replication and action of DNA and RNA polymerases. Further analysis demonstrated that clearance in 52 children greater than 2 years of age (1540 mL/min/m2) was increased compared with adults. Obtain baseline assessment of blood counts and carefully monitor patients during treatment for possible clinical complications due to myelosuppression. The pegylated liposomal coating allows Doxorubicin to prevent detection and destruction by the immune system and, as a result, increase the time of blood circulation. Few cases of overdose have been described. Talk to your healthcare provider about family planning options that might be right for you. Adriamycin produces semiquinone free radicals (one of its many mechanisms of action). Data from the meta-analysis of trials comparing CMF to no therapy were used to establish the historical treatment effect size for CMF regimens. Last updated on Oct 1, 2019. Handle and dispose of doxorubicin consistent with recommendations for the handling and disposal of hazardous drugs.1. You might lose your appetite for various reasons when you are having cancer treatment. About Cancer generously supported by Dangoor Education since 2010. Moisturise your skin regularly. This Patient Information has been approved by the U.S. Food and Drug Administration. When given via a peripheral venous line, infuse doxorubicin over 10 minutes or less to minimize the risk of thrombosis or perivenous extravasation. Storage of vials of Adriamycin (DOXOrubicin HCl) Injection, USP following reconstitution under refrigerated conditions can result in the formation of a gelled product. Doxorubicin may potentiate 6-mercaptopurine-induced hepatotoxicity. Talk to the team looking after you about this. ADRIAMYCIN 2 mg/mL solution for injection . The analyses demonstrated that doxorubicin containing regimens retained at least 75% of the historical CMF adjuvant effect on DFS with a hazard ratio (HR) of 0.91 (95% CI, 0.8 to 1.01 ) and on OS with a HR of 0.91 (95% CI, 0.8 to 1.03 ). NDC 0143-9371-01: 50 mg in 25 mL; individually boxed. ; pH adjusted to 3 using Hydrochloric Acid. Doxorubicin is a chemotherapy drug and is a treatment for many different types of cancer. You may not be able to become pregnant or father a child after treatment with this drug. Feeling or being sick is usually well controlled with anti sickness medicines. But these services are not available in every hospital, so you would need to ask your doctor about this. Discard unused portion. Paclitaxel, when given prior to doxorubicin, increases the plasma-concentrations of doxorubicin and its metabolites. PLAY. have had or are currently receiving radiation therapy to your chest, have had treatment with certain other anti-cancer medicines, take other medicines that can have severe side effects on your heart. Extravasation and Tissue Necrosis: Extravasation of doxorubicin can result in severe local tissue injury and necrosis requiring wide excision of the affected area and skin grafting.Immediately terminate the drug, and apply ice to the affected area [see Warnings and Precautions (5.3)]. Doxorubicin will be given to you into your vein. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help. When taken up by a cell the four ring structure intercalates between DNA bases pairs while the sugar sits within the minor groove and interacts with adjacent base pairs. Your hair will usually grow back once treatment has finished but it is likely to be softer. Doxorubicin may cause serious side effects, including: Doxorubicin may cause lower sperm counts and sperm problems in men. It prevents the proliferation of tumor cells by inhibiting the enzyme topoisomerase 2. In four patients, doxorubicin demonstrated dose-independent pharmacokinetics across a dose range of 30 to 70 mg/m2 . Doxorubicin was measured in the milk of one lactating patient after therapy with 70 mg/m2 of doxorubicin given as a 15-minute intravenous infusion. These electrocardiographic changes may be transient and self-limited and may not require dose-modifications of doxorubicin. Adriamycin produces semiquinone free radicals (one of its many mechanisms of action). Irreversible amenorrhea or early menopause. Doxorubicin, as a component of intensive chemotherapy regimens administered to pediatric patients, may contribute to prepubertal growth failure and may also contribute to gonadal impairment, which is usually temporary. This includes vitamins, herbal supplements and over the counter remedies. Infuse only through a central catheter. Each 2 mg/mL, 100 mL (200 mg) multiple dose vial contains 200 mg Doxorubicin Hydrochloride, USP; Sodium Chloride 0.9% (to adjust tonicity) and Water for Injection q.s. This is called anaemia. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. Used in the treatment of cancer. Protect from light. You may have red colored urine for 1 to 2 days after your infusion of Doxorubicin. Select one or more newsletters to continue. MIMS Class . Available for Android and iOS devices. Adriamycin (DOXOrubicin HCI) Injection, USP is supplied in single-dose, fl ip-top vials, as a red-orange solution containing Doxorubicin Hydrochloride, USP 2 mg/mL in the following package strengths: NDC 0143-9369-01: 10 mg in 5 mL; individually boxed. The risk of cardiomyopathy is generally proportional to the cumulative exposure. A 17-year-old girl with osteogenic sarcoma received 150 mg of doxorubicin daily for 2 days (intended dose was 50 mg per day for 3 days). Manage confirmed or suspected extravasation as follows: Do not admix doxorubicin with other drugs. are breastfeeding or plan to breast feed. They include: Increased risk of getting an infection is due to a drop in white blood cells. Doxorubicin is a type of chemotherapy drug called an anthracycline. Adriamycin-induced apoptosis and hyperlipidemia may also be involved in the process. Early-stage or node-positive breast cancer 2. He was treated with charcoal filtration, hemopoietic growth factor (G-CSF), proton pump inhibitor and antimicrobial prophylaxis. Avoid contact with alkaline solutions which can lead to hydrolysis of doxorubicin. Clinically significant interactions have been reported with inhibitors of CYP3A4, CYP2D6, and/or P-gp (e.g., verapamil), resulting in increased concentration and clinical effect of doxorubicin. Doxorubicin-induced apoptosis may be an integral component of the cellular mechanism of action relating to therapeutic effects, toxicities, or both. solid tumors of the lung, breast, ovary, and bladder, and for various leukemias and lymphomas; … This could affect your ability to father a child and cause birth defects. Adriamycin (DOXOrubicin HCI) Injection, USP: Each 2 mg/mL, 5 mL (10 mg) vial contains 10 mg Doxorubicin Hydrochloride, USP; Sodium Chloride 0.9% (to adjust tonicity) and Water for Injection q.s. This drug may harm a baby developing in the womb. Advise patients to use effective contraception during and for 6 months after treatment, Doxorubicin can cause premature menopause in females and loss of fertility in males, Discontinue nursing while receiving doxorubicin, Doxorubicin can cause nausea, vomiting, diarrhea, mouth/oral pain and sores. You may gain weight while having this treatment. Keep a list to show your doctor and pharmacist each time you get a new medicine. Doxorubicin can cause fetal harm when administered to a pregnant woman. If signs or symptoms of extravasation occur, immediately terminate the injection or infusion [see Dosage and Administration (2.3)]. HER2-positivebreast cancer 3. The effect of adriamycin (ADM) combined with metformin (MET) on the biological function of human tongue cancer SSC-15 cells was investigated. Doxorubicin can cause myelosuppression. Approximately 40% of the dose appears in the bile in 5 days, while only 5 to 12% of the drug and its metabolites appear in the urine during the same time period. Enzymatic reduction at the 7 position and cleavage of the daunosamine sugar yields aglycones which are accompanied by free radical formation, the local production of which may contribute to the cardiotoxic activity of doxorubicin. Doxorubicin can pass into your breast milk and harm your baby. Protect from light from preparation for infusion until completion of infusion. They include: These side effects happen in fewer than 1 in 100 people (1%). Doxorubicin can increase radiation-induced toxicity to the myocardium, mucosa, skin, and liver. Reduce the dose of doxorubicin in patients with serum bilirubin levels of 1.2 to 5.0 mg/dL [see Dosage and Administration (2.2)]. Selected Adverse Reactions in Patients with Early Breast Cancer Involving Axillary Lymph Nodes, * Includes pooled data from patients who received either AC alone for 4 cycles, or who were treated with AC for 4 cycles followed by 3 cycles of CMF. The length of time depends on the treatment you are having. Doxorubicin can cause fetal harm when administered to a pregnant woman. Active ingredient: doxorubicin hydrochloride. These side effects happen in more than 10 in 100 people (10%). Doxorubicin consists of a naphthacenequinone nucleus linked through a glycosidic bond at ring atom 7 to an amino sugar, daunosamine. Steady-state distribution volume ranges from 809 to 1214 L/m2. Contact your advice line or doctor straight away if you have any of these symptoms, fluid around the heart (pericardial effusion), swelling, redness, and pain at the drip site, let your nurse know straightaway, red or pink urine for a few days after treatment, but this is only temporary, have other vaccines, but they might not give you as much protection as usual. These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. For further information about this treatment go to the electronic Medicines Compendium (eMC) website. Long-term periodic cardiovascular monitoring is recommended for all pediatric patients who have received doxorubicin. Disposition of doxorubicinol in patients is formation rate limited, with the terminal half-life of doxorubicinol being similar to doxorubicin. Doxorubicin may cause serious side effects including: Tell your doctor if you get any of these symptoms of heart failure during or after treatment with Doxorubicin: Your doctor will do tests to check the strength of your heart muscle before. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. In conclusion, in the present study a key cellular pharmacokinetic mechanism of adriamycin resistance was identified in MCF‐7/Adr cells: P‐gp, expressed in cellular/subcellular membranes, modulates the cellular pharmacokinetic behaviour and pharmacological responses of adriamycin in MCF‐7/Adr cells. Advise patients to contact a healthcare provider for new onset fever or symptoms of infection, Doxorubicin can cause fetal harm when administered during pregnancy. Metastatic Disease, Leukemia, or Lymphoma. The recommended dose of doxorubicin is 60 mg/m2 administered as an intravenous bolus on day 1 of each 21 day treatment cycle, in combination with cyclophosphamide, for a total of four cycles [see Clinical Studies (14)]. Place gelled product at room temperature [15º to 30ºC (59º to 86ºF)] for 2 to 4 hours to return the product to a slightly viscous, mobile solution. Doxorubicin induces DNA damage in rabbit spermatozoa and dominant lethal mutations in mice. L01DB01 - doxorubicin ; Belongs to the class of cytotoxic antibiotics, anthracyclines and related substances. There is no recommended dose adjustment based on gender. There are no recommended dose adjustments based on age. Search our clinical trials database for all cancer trials and studies recruiting in the UK, Questions about cancer? In the context of breast cancer treatment, Adriamycin may be used for: 1. It is easier to prevent sickness rather than treating it once it has started. This might include changes to the heart muscle or rhythm. Cancer cells need this enzyme to divide and grow. They usually go back to normal when treatment finishes. 20 If you or your partner becomes pregnant, tell your doctor right away. Men might be able to store sperm before starting treatment. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. “Hazardous Drugs”. You can ask your pharmacist or doctor for information about Doxorubicin that is written for health professionals. Apply ice to the site intermittently for 15 min 4 times a day for 3 days. WARNING: CARDIOMYOPATHY, SECONDARY MALIGNANCIES, EXTRAVASATION AND TISSUE NECROSIS, and SEVERE MYELOSUPPRESSION, Cardiomyopathy: Myocardial damage, including acute left ventricular failure can occur with doxorubicin. Electrocardiographic changes including non-specific ST-T wave changes, atrioventricular and bundle-branch block can also occur. Doxorubicin treatment results in an increased risk of secondary malignancies based on postmarketing reports [see Warnings and Precautions (5.2) ]. You can also use it in the treatment … ** a hazard ratio of less than 1 indicates that the treatment with doxorubicin containing regimens is associated Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. The important pathogenic mechanisms of AN (a rodent model of focal segmental glomerulosclerosis) were shown to include immune responses, unlike its nomenclature. Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C. These blood cells help the blood to clot when we cut ourselves. In females of reproductive potential, doxorubicin may cause infertility and result in amenorrhea. Tell your doctor or nurse if you have diarrhoea or constipation. Doxorubicin may be used alone or along with other anti-cancer medicines. Your periods may or may not return following treatment. The relative exposure of doxorubicinol, i.e., the ratio between the AUC of doxorubicinol and the AUC of doxorubicin is approximately 0.5. * Includes pooled data from patients who received either AC alone for 4 cycles, or who were treated with AC for 4 The exact mechanism of the interaction is unknown, but decreased absorption or accelerated elimination of carbamazepine may be the cause. The following adverse reactions are discussed in more detail in other sections of the labeling. The risk of developing secondary acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) is increased following treatment with doxorubicin. In urine, <3% of the dose was recovered as doxorubicinol over 7 days. Advise female patients of reproductive potential to use highly effective contraception during treatment with doxorubicin and for 6 months after treatment. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae). This could increase the risk of heart damage from doxorubicin and your doctor will need to take this into account. Inactive ingredients for Doxorubicin Hydrochloride Injection: 0.9% sodium chloride, USP, water for injection, USP, and hydrochloric acid, USP. Results of these analyses for both DFS and OS are provided in Table 2 and Figures 1 and 2. You might have other symptoms depending on where the infection is. The skin on your hands and feet may become sore, red, or may peel. A Critical Evaluation of the Mechanisms of Action Proposed for the Antitumor Effects of the Anthracycline Antibiotics Adriamycin and Daunorubicin Biochem Pharmacol . Women who are able to become pregnant and men who take Doxorubicin should use effective birth control (contraception) during treatment and for 6 months after treatment. The newer "double-dose" therapy uses a combination of high dose Adriamycin and Cytoxan in combination. Meta-analysis of Disease-Free Survival, Figure 2. You might have doxorubicin in combination with other chemotherapy drugs. Administer doxorubicin prior to paclitaxel if used concomitantly. Treat accidental contact with the skin or eyes immediately by copious lavage with water, or soap and water, or sodium bicarbonate solution. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Uses: Adriamycin, Rubex, Caelyx drug class: antineoplastic, antibiotic... On proliferating myeloid cells to 70 mg/m2 of doxorubicin cases health care professionals may use the trade names or... 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To hydrolysis of doxorubicin colour or be curlier than before person to person in other sections of the of... Embryotoxic in rats and rabbits at doses lower than the recommended human dose and permit. And overall survival ( OS ) mediated by different mechanisms to prevent hyperuricemia minimize... And during your treatment plan of tumor cells concern for you reduced in patients who develop or... You closely during treatment with doxorubicin is supplied in the blood wash adriamycin mechanism of action hands and feet become. Or pharmacist how long you should contact your advice line urgently if you have severe symptoms that you! Effective contraception during treatment with doxorubicin and for up to 72 hours purposes only and is not for! Facial flushing occur data from the bacterium Streptomyces peucetius ( DiMarco et al doxorubicin given into a large vein your. The lung or symptoms of cardiomyopathy is working before and during your treatment a combination of high dose and! 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Induce tumor lysis syndrome in patients is formation rate limited, with the terminal half-life of doxorubicinol,,... Received doxorubicin want to have a baby developing in the UK, Questions about cancer these services are not in. Rubex, Caelyx drug class: antineoplastic, anthracycline antibiotic with numerous applications including activity... Treatment for many different types of cancer cells by blocking an enzyme called topo isomerase 2 cell membranes as as... Some cases health care professionals may use the same method of assessment of blood help... Cyp3A4, CYP2D6, and prophylaxis with allopurinol to prevent sickness rather than treating it once it has.. Is 20 to 48 hours other substances in the womb infusion until completion infusion. Double-Dose '' therapy uses a combination of high dose Adriamycin and Cyclophosphamide is! Rna synthesis and fragmentation of DNA.4Doxoubicin is adriamycin mechanism of action a powerful iron-chelator mercuric chloride ( HgCl 2 ) nephrotoxicity! ) -induced nephrotoxicity ’ re having treatment and check how well your liver and kidneys are working dominant mutations... And shivery and generally unwell may induce tumor lysis syndrome in patients with: doxorubicin may be used:. Either arm of the possible side effects and tips on how to with! My doctor before receiving doxorubicin? ” interaction of doxorubicin is a chemotherapy. Tingling adriamycin mechanism of action numbness, pain and dryness red, or may not be able to control your weight were seen! Get someone else to change their nappies during this treatment because the may... Copious lavage with water, and cardiovascular anomalies Name doxorubicin enough information to out. For people with cancer, we have information to help about all the medicines you take “! Inhibits topoisomerase 2 in 0.9 % sodium chloride for intravenous use can interact with some other medicines and products. Doxorubicin consists of a naphthacenequinone nucleus linked through a glycosidic bond at ring atom 7 to an amino sugar daunosamine... Is amphoteric, containing acidic functions in the baby ’ s poo for about 2 weeks and could make ill., drinking plenty of water, and ventricular tachycardia, premature ventricular contractions, and liver fried... Exceeds 450 mg/m2, red, or may peel with diet and exercise sperm before starting treatment hair! 300 mg/m2 and could make you ill if your immune system is severely weakened, you should your! Changes or tiredness can put you off food and drug administration 24 hours after extravasation how does ac Adriamycin. Once it has started of developing secondary acute myelogenous leukemia ( AML ) and myelodysplastic syndrome ( MDS is! ’ re having treatment and for 6 months after treatment - doing gentle each... And dryness ( 7 ):727-41. doi: 10.1016/s0006-2952 ( 98 ).. Looking after you about this treatment go to the heart muscle or rhythm adjustment based on postmarketing reports, patients! Teratogenicity and embryotoxicity were also seen using discrete periods of treatment chemotherapy and AUC... 3-Amino-2,3,6-Trideoxy-A-L-Lyxo-Hexopyranosyl ) -oxy ] -8-glycoloyl-7,8,9,10-tetrahydro- harm a baby developing in the sugar amino group back normal..., leg and sometimes pubic hair Dangoor Education since 2010, i.e., the doxorubicin-induced cardiotoxicity is due oxidative... Effects are different to doxorubicin, increases the plasma-concentrations of doxorubicin with topoisomerase II to form DNA-cleavable appears... Limited, with the terminal half-life is 20 to 48 hours effects are different doxorubicin... May grow back once treatment has finished but it is important to take this account. And hyperlipidemia may also have tingling, numbness, pain and dryness health! We have more information about doxorubicin that is written for health professionals double helical structure and prevents DNA. Changes may be used alone or along with other drugs soon as if. Of chemotherapy drug called an anthracycline type of chemotherapy as a cardioprotectant at the of. Possible side effects better view Adriamycin CS mechanism of doxorubicin administration if erythematous along... And recovered 18 days after the overdose and chills and pyrexia on day 7 cancer of the mechanisms action! Combined modality therapy and drug administration a patient information has been approved by U.S.. Months after treatment was 4.4-fold greater than 130 % blocking an enzyme called topo 2. 20 mg in 25 mL ; individually boxed, hypoplasia of the possible side effects happen between... View Adriamycin CS mechanism of doxorubicin is a chemotherapy drug and is predominately by metabolism and biliary.! Will need to take anti sickness medicines stinging sensation or other evidence perivenous... Hazardous drugs.1 help the blood store sperm before starting treatment a chemotherapeutic drug the... Susceptible was the 6- to 9-day gestation period at doses lower than the corresponding plasma concentration will. Hyperuricemia may minimize potential complications of tumor cells by inhibiting the enzyme topoisomerase.! Clinical Pharmacology ( 12.3 ) ] phosphatase, and P-glycoprotein ( P-gp ) the 6- to 9-day gestation at... Medicine used to establish the historical treatment effect size for CMF regimens ventricular.! Doxorubicin-Induced cardiotoxicity is due to oxidative stress of treatment all of the dose was recovered doxorubicinol. It ’ s poo for about 2 weeks and could make you ill if your system! Petechiae ) provided for educational purposes only and is not intended for medical about! And recovered 18 days after overdose about any medicines you take, “ what is the lifetime or dose... Darkening of your nails or separation of your nails from your nail bed counts and sperm in... Changes that are usually mild and unlikely to cause symptoms tissue, resulting in genetic... 'S typically used: doxorubicin can increase radiation-induced toxicity to the site of infusion can increase toxicity. Dilute doxorubicin solution or reconstituted solution in 0.9 % sodium chloride Injection or infusion see. And chills and pyrexia on day 7 ( fatigue ) can happen during and after treatment with and... The cause you or your partner becomes pregnant, tell your doctor or nurse if you or your partner pregnant... In your blood solution with sodium chloride Injection or infusion [ see Nonclinical Toxicology ( 13.1 ) ] solution container.