Doxorubicin

Injection (per vial):

• 10mg
• 50mg

• Consider lower dose or longer interval between cycles in heavily pretreated, elderly or obese patients
• Administer over 3-5 min
• Monitor for local erythematous streaking along vein and/or facial flushing which may indicate too rapid administration

Anthracycline anticancer

It binds and intercalates into DNA, inhibiting nucleic acid and protein synthesis. It triggers DNA cleavage by topoisomerase II

• Alopecia
• Nausea & vomiting
• Anorexia
• Diarrhea
• Mucositis
• Stomatitis
• Esophagitis
• Abdominal pain
• Increased ALT/AST
• Conjunctivitis
• Keratitis
• Lacrimation
• Hot flashes
• Thrombophlebitis
• Onycholysis
• Nail-bed hyperpigmentation
• Rash
• Pruritus
• Photosensitivity
• Asthenia
• Fever
• Rigors
• Leukopenia
• Infection
• Sepsis
• Urine discoloration
• CHF
• Hyperuricemia
• Venous streaking

• Hypersensitivity to class/components
• Active infection
• Severe hepatic impairment
• Baseline neutrophil count <1500/mm³
• Recent MI or severe myocardial insufficiency
• Prior treatment max dose of doxorubicin, daunorubicin, idarubicin or other anthracyclines
• Cardiomyopathy, CHF, impaired cardiac function
• Severe arrhythmia
• Severe persistent drug-induced myelosuppression
• Breastfeeding during treatment and for 10 days after discontinuing
• IM/SC administration
• Trastuzumab use within 7 months

WARNING:

• Myocardial damage including acute left ventricular failure may occur during treatment or months to years after treatment is discontinued
• Secondary acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) occur at a higher incidence in patients treated with anthracyclines, including doxorubicin hydrochloride
• Severe myelosuppression resulting in serious infection, septic shock, requirement for transfusions, hospitalization, and death may occur
• Extravasation leading to severe local tissue injury and necrosis requiring wide excision of affected area and skin grafting

• Talimogene
• Live bacterial vaccine