III. Mechanism

  1. See Antibiotic Chemotherapy
  2. This formulation is a non-liposomal preparation of Doxorubicin
    1. See Liposomal Doxorubicin
  3. Doxorubicin is a derivative of Daunorubicin, an anthracycline Aminoglycoside antineoplastic
    1. Daunorubicin is isolated from the bacterium Streptomyces peucetius (Caesius variety)
    2. Doxorubicin is a hydroxylated form of Daunorubicin
  4. Doxorubicin inserts between adjacent DNA base pairs
    1. Blocks DNA Transcription by RNA Polymerase
  5. Doxorubicin also inhibits Topoisomerase 2
    1. Inhibits normal Nucleotide strand ligation during DNA Replication
  6. Doxorubicin also induces free radical formation with several secondary effects
    1. Lipid peroxidation of cell membrane lipids (cytotoxic effects)
    2. Toxic effects (esp. cardiovascular adverse effects)

IV. Medications

  1. Doxorubicin IV Solution: 2 mg/ml in 5, 10, 25 and 100 ml vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Severe skin and soft tissue necrosis on extravasation
    1. Doxorubicin is a strong Vesicant (causes Blistering)
  2. Cardiotoxicity (esp. children)
    1. Risk of Congestive Heart Failure (esp. with multiple doses)
  3. Myelosuppression
  4. Hyperuricemia
  5. Infusion reactions (severe)
  6. Alopecia
  7. Mucositis
  8. Necrotizing colitis
  9. Palmar-Plantar erythrodysesthesia
  10. Carcinogenic (risk of secondary malignancy)
  11. Urine Discoloration (transient red coloration)

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function Tests
    4. Serum Uric Acid
    5. Echocardiogram with ejection fraction

IX. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Ontology: Doxorubicin (C0013089)

Definition (CHV) a kind of cancer treatment drug
Definition (CHV) a kind of cancer treatment drug
Definition (NCI_NCI-GLOSS) A drug that is used to treat many types of cancer and is being studied in the treatment of other types of cancer. Doxorubicin comes from the bacterium Streptomyces peucetius. It damages DNA and may kill cancer cells. It is a type of anthracycline antitumor antibiotic.
Definition (NCI) An anthracycline antibiotic with antineoplastic activity. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. caesius, is the hydroxylated congener of daunorubicin. Doxorubicin intercalates between base pairs in the DNA helix, thereby preventing DNA replication and ultimately inhibiting protein synthesis. Additionally, doxorubicin inhibits topoisomerase II which results in an increased and stabilized cleavable enzyme-DNA linked complex during DNA replication and subsequently prevents the ligation of the nucleotide strand after double-strand breakage. Doxorubicin also forms oxygen free radicals resulting in cytotoxicity secondary to lipid peroxidation of cell membrane lipids; the formation of oxygen free radicals also contributes to the toxicity of the anthracycline antibiotics, namely the cardiac and cutaneous vascular effects.
Definition (MSH) Antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of DAUNORUBICIN.
Definition (CSP) antineoplastic antibiotic obtained from Streptomyces peucetius; a hydroxy derivative of daunorubicin.
Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D004317
SnomedCT 372817009, 68444001
LNC LP18382-9, MTHU004184
English Doxorubicin, 5,12-Naphthacenedione, 10-((3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy)-7,8,9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, (8S-cis)-, (8S-cis)-10-[(3-Amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroacetyl)-1-methoxy-5,12-naphthacenedione, 14-Hydroxydaunomycin, (8S-cis)-10-[(3-Amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-5,12-naphthacenedione, Doxorubicin [Chemical/Ingredient], adr, DOXOrubicin, doxorubicin, DOXORUBICIN, Doxorubicin (product), Doxorubicin (substance), ADM, ADR, DOX, Hydroxyl Daunorubicin, Hydroxyldaunorubicin
Swedish Doxorubicin
Czech doxorubicin
Finnish Doksorubisiini
Russian DOKSORUBITSIN, ADRIABLASTIN, ADRIAMITSIN, АДРИАБЛАСТИН, АДРИАМИЦИН, ДОКСОРУБИЦИН
Japanese 塩酸ドキソルビシン, ドキソルビシン, アドリアシン, アドリアマイシン
Spanish doxorrubicina, doxorubicina, doxorrubicina (producto), doxorubicina (producto), doxorubicina (sustancia), Clorhidrato de Doxorrubicina, doxorrubicina (sustancia), Doxorrubicina
Croatian DOKSORUBICIN
Polish Doksorubicyna, Adriamycyna
Portuguese Cloridrato de Doxorrubicina, Doxorrubicina
French Doxorubicine
German Doxorubicin
Italian Doxorubicina

Ontology: Adriamycin (C0085752)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D004317
SnomedCT 68444001
LNC LA14332-3
English Adriblastine, Bedford Brand of Doxorubicin Hydrochloride, Adriamycin, adriamycin, adriablastin, adriblastin, adriblastina, Adriblastina, Adriamycin®, Adriamycine
German Adriamycin
Spanish Adriamicina, adriamicina
Portuguese Adriamicina
Czech Adriamycin