Apr 01, 2001 compatibility and stability of vincristine sulfate, doxorubicin hydrochloride, and etoposide phosphate in 0. This is a multicenter study of combretastatin a4 phosphate ca4p. Compatibility and stability of vincristine sulfate, doxorubicin hydrochloride, and etoposide phosphate in 0. Doxorubicin hydrochloride for injection, usp 3 doxorubicin. Compare prices, print coupons and get savings tips for doxorubicin generic adriamycin and other leukemia, hodgkins lymphoma, breast cancer, lung cancer, ovarian cancer, thyroid cancer. Aug 20, 2019 doxorubicin hydrochloride hcl injection is an anthracycline topoisomerase ii inhibitor indicated. Hcl into its free base hydrophobic form through a chemical reaction with triethylamine tea, the. Doxorubicin can also be given by continuous infusion. Doxorubicin hydrochloride injection doxorubicin hydrochloride. Induction chemotherapy using doxorubicin and cisplatin.
Doxorubicin hydrochloride national cancer institute. Doxorubicin is an anthracycline type antineoplastic drug. Severe local tissue necrosis will occur if there is extravasation during administratio. It is often used together with other chemotherapy agents. Compatibility and stability of vincristine sulfate, doxorubicin. Previously recommended that total cumulative dose of doxorubicin hydrochloride not exceed 550 mgm 2 because of risk of potentially irreversible cardiotoxicity, but higher cumulative doses may be tolerated, particularly when dexrazoxane zinecard is used.
Rarely, doxorubicin is given by injection into an artery. Five milliliters of doxorubicin hydrochloride liposome injection 0. What are the doses of doxorubicin to be administered i. Doxorubicin is used in combination with other medications to treat certain types of bladder, breast, lung, stomach, and ovarian cancer. Doxorubicin administration all ons member community. Administer over 35 min with frequent checks of iv patency via visible blood return. Each 20 mg lyophilized vial contains 20 mg of doxorubicin hydrochloride, usp and 100 mg of lactose monohydrate, nf. Doxorubicin lipid complex is also used to treat kaposis sarcoma a type of cancer that causes abnormal tissue to grow on different parts of the body related to acquired immunodeficiency syndrome aids that has not improved or that has worsened after. Identify issues surrounding stability and compatibility of iv therapies. Approved api for cancer therapeutic use doxorubicin hcl.
Doxorubicin intravenous route description and brand names. Patients receive doxorubicin hydrochloride intravenous iv over 20 minutes, paclitaxel iv over 60 minutes, gemcitabine hydrochloride iv. Find out what health conditions may be a health risk when taken with doxorubicin intravenous. Doxorubicin, hydrochloride salt, 99% lc laboratories. Protect from light following preparation until completion of infusion. It binds 67 to cell membranes as well as plasma proteins.
Adriamycin iv, adriamycin pfs iv, adriamycin rdf iv, rubex iv. Doxorubicin lipid complex is also used to treat kaposis. Doxorubicinolcd3 hcl mixture of diasteromers cas no. Doxorubicin fda prescribing information, side effects. Doxorubicin 60mgm2 iv day 1 cyclophosphamide 600mgm2 iv day 1 cycle frequency. Treatment repeats every 14 days for 4 courses in the absence of disease progression or unacceptable toxicity. Doxorubicin hydrochloride is an orangered, crystalline, hygroscopic powder that is soluble in water and slightly soluble in methanol. Definition from the nci drug dictionary detailed scientific definition and other names for this drug. Doxorubicin injection is used together with other medicines to treat cancer of the blood, lymph system, bladder, breast, stomach, lungs, ovaries, thyroid, nerves, kidneys, bones, and soft tissues, including. Doxorubicin hydrochloride doxorubicin hydrochloride dose. Additive compatibility drugs in syringe compatibility.
Ysite compatibility for conventional doxorubicin hydrochloridehid. In summary, doxorubicin is a very useful chemotherapy drug used in a multitude of diagnoses and is commonly seen in the outpatient setting for the treatment of breast cancer, lymphomas, and leukemias. Used 2um doxorubicin hydrochloride to treat neonatal rat ventricular myocytes for 12 hr to 24 hr, see clear effect of cell damage. This includes breast cancer, bladder cancer, kaposis sarcoma, lymphoma, and acute lymphocytic leukemia. The drug should be administered under the supervision of an experienced cancer chemotherapy physician. Jun 04, 2012 doxorubicin is a prescription medication used to treat certain types of cancer in adults and children including breast cancer, lung cancer, and ovarian cancer. Doxorubicin is an anthracycline type of chemotherapy that is used to treat several different types of cancer. Doxorubicin comes as a solution liquid or as a powder to be mixed with liquid to be injected intravenously into a vein by a doctor or nurse in a medical facility. Doxorubicin hydrochloride monograph for professionals. All generic drug interactions for doxorubicin iv lists will include brand. Congestive heart failure chf low platelet count thrombocytopenia loss of appetite. Assess the safety and efficacy of pegfilgrastim in these patients. Undetectable or low plasma concentrations of doxorubicinol reported after singledose iv administration.
Doxorubicin 40 mgm2 iv on day 1 in combination with cyclophosphamide 750 mgm2 iv on day 1 and vincristine 1. Iv geriatric patients, debilitated patients, or asa iii iv. Doxorubicin is a major substrate of cytochrome p450 cyp3a4 and cyp2d6, and pglycoprotein pgp. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you. Medicines are sometimes prescribed for purposes other than those listed in a patient information leaflet. The optimal dose of dox in chemotherapy has been developed for patients suffering from breast cancer khaloozadeh et al. The anthracycline ring is lipophilic, but the saturated end of the ring system contains abundant hydroxyl groups adjacent to the amino sugar, producing a hydrophilic center. May cause eye, skin, or respiratory system irritation.
Doxorubicin intravenous route description and brand. Doxorubicin hydrochloride injection, usp is a sterile parenteral, isotonic, available in 5 ml 10 mg, 10 ml 20 mg, 25 ml 50 mg, and 37. A 2001 swiss study by gabizon reports minimal reactions when the initial infusion rate is 0. Doxorubicin injection is used together with other medicines to treat cancer of the blood, lymph system, bladder, breast, stomach, lungs, ovaries, thyroid, nerves, kidneys, bones, and soft tissues, including muscles and tendons. Clinical trials using doxorubicin hydrochloride national. Doxorubicin pi may 8, 2003 3 65 sugar, producing a hydrophilic center. Doxorubicin 15 mgm 2 civi, dacarbazine 250 mgm 2 civi days 1 through 4, repeat every 21 days. In australia we have a centralised chemotherapy protocol data eviq and it has agents like doxorubicin as a bolus or iv infusion.
Doxorubicin free base, also called doxorubicin, is an anthracycline antibiotic with antineoplastic activity. Doxorubicin 60 mgm 2 iv day 1, dacarbazine 250 mgm 2 civi days 1 through 5, repeat every 21 days. Each 10 mg lyophilized vial contains 10 mg of doxorubicin hydrochloride, usp and 50 mg of lactose monohydrate, nf. Doxorubicin 2 mgml concentrate for solution for infusion. Cardiac toxicity with doxorubicin may occur at lower cumulative doses whether or. Doxorubicin is mutagenic as it induced dna damage in rabbit spermatozoa and dominant lethal mutations in mice. Mar 18, 2015 doxorubicin 60 mgm 2 iv, dacarbazine 750 mgm 2 iv day 1, repeat every 21 days. Doxorubicin liposomal dosage guide with precautions. The risk of cardiotoxicity increases with higher cumulative doses of anthracyclines 47.
Doxorubicin hydrochloride is an orangered, crystalline, hygroscopic powder that is soluble in. Risk of developing chf increases rapidly with increasing total cumulative dosages 450 mgm 2. Hcl has a characteristic absorbance peak at 480 nm. Patients receive doxorubicin iv over 510 minutes and cisplatin iv over 3060 minutes on day 1. The iv drug compatibility chart is based on information from the handbook of injectable drugs, 16th edition, by lawrence a. Compatibility and stability of vincristine sulfate. Stability and compatibility of four anthracyclines. This drug is compatible with 5% dextrose injection. Clinical trials are research studies that involve people. This information leaflet does not take the place of talking with your. Doxorubicin, isolated from the bacterium streptomyces peucetius var. Doxorubicin definition of doxorubicin by the free dictionary. Doxorubicin hydrochloride reference guide for safe and effective use from the american society of.
Jun 08, 2018 doxorubicin binds to nucleic acids, presumably by specific intercalation of the planar anthracycline nucleus with the dna double helix. This agent has earned its infamous nickname, the red devil, based on its bright red koolaid red color, vesicant properties, and sideeffect. Administer doxorubicin hcl as an intravenous injection through a central. Doxorubicin belongs to a group of drugs called anthracyclines, which slow and stop the growth of cancer cells. Doxorubicin works by slowing or stopping the growth of cancer cells. The most dangerous side effect of doxorubicin is dilated cardiomyopathy, leading to congestive heart failure. Anthracyclines have become one of the most important drugs for the treatment of both hematological and solid tumors. Doxorubicin side effects, uses, dosage, overdose, pregnancy. Material may be irritating to the mucous membranes and upper respiratory tract. Doxorubicin lipid complex is used to treat ovarian cancer that has not improved or that has worsened after treatment with other medications. Doxorubicin solution for injection summary of product. Heart muscle disease cardiomyopathy skin and nail discoloration.
Webmd provides common contraindications for doxorubicin intravenous. Doxorubicin hydrochloride hcl injection is an anthracycline topoisomerase ii inhibitor indicated. Four versus six cycles of cyclophosphamidedoxorubicin or. Gemcitabine, paclitaxel, doxorubicin in metastatic or. Other cas numbers previously assigned to doxorubicin, namely 23257172, 24385088, 25311506, and 29042306, have been deleted by cas and are no longer in use. The book begins by tracing the discovery and development of doxorubicin, highlighting factors such as a the involvement of organic chemistry at an early stage, which allowed the rapid identification of doxorubicin. Doxorubicin binds directly to dna via intercalation between base pairs on the dna. Doxorubicin consists of a naphthacenequinone nucleus linked through a glycosidic bond at ring atom 7 to an amino sugar, daunosamine. Rednessswelling pain on the palms of the hands andor the soles of the feet. The syringe needle is placed directly into the vein or central line and the drug is given over several minutes. Doxorubicin 40 mgm2 iv on day 1 in combination with cyclophosphamide 1,000 mgm2 iv on day 1 and vincristine 1 mgm2 max of 2mg iv. Until detailed compatibility information about miscibility is available, doxorubicin should not be. Doxorubicin was excreted in the milk of one lactating patient, with peak milk concentration at 24 hours after treatment being approxi er therapy with 70 mgm. Doxorubicin pi may 8, 2003 1 1 2 doxorubicin hydrochloride for injection, usp 3 4 doxorubicin hydrochloride injection, usp 5 6 rx only 7 8 for intravenous use only 9 10 warning 11 1.
Doxorubicin and dacarbazine ad regimen for soft tissue sarcomas. Unused solutions of the multiple dose vial remaining beyond the recommended storage times should be discarded. Doxorubicin, sold under the brand name adriamycin among others, is a chemotherapy medication used to treat cancer. Hodgkins lymphoma hodgkins disease and nonhodgkins lymphoma.
Iv ozone, high dose vitamin c booklet index page no. Until specific compatibility data are available, it is not recommended that doxorubicin be. Patients also receive filgrastim gcsf subcutaneously sc on days 321 or pegfilgrastim. The dosage of this drug depends on dosage regimen, general status and previous treatment of the patient. It may also be used to treat other kinds of cancer, as determined by your doctor. Doxorubicin 60 mgm 2 iv, dacarbazine 750 mgm 2 iv day 1, repeat every 21 days. Incompatibilities are based on meeting any of the following criteria. Doxorubicin hydrochloride safety data sheet supersedes revision. Trissel, fashp, 2010, american society of healthsystem pharmacists.
Doxorubicin is given as an intravenous injectable over approximately 10 minutes in an iv drip. Ncis basic information about clinical trials explains the types and phases of trials and how they are carried out. Anticancer antibiotics details the development of doxorubicin as a widespectrum antitumor antibiotic. Comparison of safety and toxicity of liposomal doxorubicin. Doxorubicin dox is a commonly used drug in anthracyclines. Doxorubicin and dacarbazine ad regimen for soft tissue. The compatibility of doxorubicin hydrochloride liposome injection with selected other drugs during simulated ysite administration was studied.
Doxorubicin hydrochloride is soluble in organic solvents such as ethanol and dmso, which should be purged with an inert gas. Doxorubicin hydrochloride is also available in a different form called doxorubicin hydrochloride liposome. Doxorubicin hydrochloride, usp is an anthracycline topoisomerase ii inhibitor indicated. Critically analyse the potential complications associated with iv therapy and discuss appropriate actions to prevent andor treat these complications. Doxorubicin hcl is the salt form of doxorubicin, which make doxorubicin more soluble in water and possible to be injected intravenously in saline solution or dextrose 5%. Doxorubicin hydrochloride for injection, usp doxorubicin. Your medicine will be given to you as part of an intravenous. Slow infusion rate of doxorubicin induces higher pro. Doxorubicin is a potent medication and should always be stored in its original container, far out of the reach of children and pets. Doxorubicin is given through a vein by intravenous injection iv. Doxorubicin 50 mgm2 iv on day 1 in combination with cyclophosphamide 800 mgm2 iv on day 1 and vincristine 1.
A rapid isocratic technique was developed for the analysis of four anthracyclines doxorubicin, epirubicin, daunorubicin and pirarubicin in parenteral solutions using high pressure liquid chromatography hplc with fluorescence detection and a c18 hypersil ods column. Tocris bioscience is the leading supplier of novel and. Save money on your adriamycin pfs injection prescription by switching to tevas fdaapproved generic version, doxorubicin hydrochloride injection, usp. The solubility of doxorubicin hydrochloride in these solvents is approximately 1 and 10 mgml, respectively. Intravenous iv administration of doxorubicin must be very careful and it is advisable to give the medicinal product via the tubing of a freely running intravenous sodium chloride 9 mgml 0. Consider use of the lower dose in the recommended dose range or longer intervals. Jan 27, 2003 patients receive cyclophosphamide iv and doxorubicin hydrochloride iv on day 1. Compare prices, print coupons and get savings tips for doxorubicin generic adriamycin and other leukemia, hodgkins lymphoma, breast cancer, lung cancer, ovarian cancer, thyroid cancer, stomach cancer, soft tissue sarcoma, and neuroblastoma drugs at cvs, walgreens, and other pharmacies. Mar 31, 2015 dilute doxorubicin hydrochloride injection solution in 0. The rate of cardiomyopathy is dependent on its cumulative dose, with an incidence about 4% when the dose of doxorubicin is 500550 mgm 2, 18% when the dose is 551600 mgm 2 and 36% when the dose exceeds 600 mgm 2. Administered into the tubing of a freely running intravenous infusion of ns or d5w. Conventional anthracyclines have a relatively low therapeutic index.
Dailymed doxorubicin hydrochloride injection, solution. Iv geriatric patients, debilitated patients, or asa iii iv patients. Doxorubicin is a cytotoxic anthracycline antibiotic isolated from cultures of streptomyces peucetius var. The molecule is amphoteric, containing acidic 66 functions in the ring phenolic groups and a basic function in the sugar amino group. Maintenance2575 mcgkgmin infusion or incremental bolusesof1020mg. Compatibility of doxorubicin hydrochloride liposome. Follow applicable special handling and disposal procedures. Doxorubicin hydrochloride api raw material supplier. The clinical trials on this list are studying doxorubicin hydrochloride. Drug dose iv infusionoral q cyclophosphamide 500mgm2 iv day 1 vincristine 1. Myocardial damage, including acute left ventricular failure, can occur with doxorubicin hydrochloride.