Monograph Details
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Neoplasms
> Cytotoxic antibiotics
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ADRIAMYCIN |
| Manufacturer |
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Bedford Laboratories |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Anthracycline antibiotic. |
| Generic Name |
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Doxorubicin HCl 10mg/vial, 20mg/vial, 50mg/vial; pwd for IV inj after reconstitution; contains lactose. |
| Also |
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• ADRIAMYCIN SOLUTION
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| Indications |
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Disseminated neoplasias (eg, acute lymphoblastic leukemia, acute myeloblastic leukemia, Hodgkin's disease, malignant lymphoma, neuroblastoma, Wilms' tumor, soft tissue and bone sarcomas; breast, ovarian, bladder, thyroid, lung, gastric carcinoma). Adjunct in breast cancer after resection. |
| Adults and Children |
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Monotherapy: usually 60–75mg/m2 IV every 21 days. Combination therapy: usually 40–60mg/m2 IV every 21 to 28 days. Hyperbilirubinemia, inadequate bone marrow reserves: reduce dose. |
| Contraindications |
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Severe myelosuppression (baseline neutrophils <1500cells/mm3) or severe hepatic impairment. Cardiac disease (eg, severe myocardial insufficiency, arrhythmias). Recent MI. Previous treatment with max cumulative doses of anthracyclines, anthracenediones. |
| Precautions |
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Pre-existing heart disease or risk thereof. Obtain baseline CBC, bilirubin, AST, creatinine, LVEF. Hepatic dysfunction. Monitor cardiac function (LVEF, ECG echocardiogram), hepatic function, CBC, uric acid levels. Avoid extravasation. Children (cardiotoxicity, impaired myocardial growth). Elderly. Pregnancy (Cat.D; use adequate contraception). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Mediastinal irradiation, cyclophosphamide, calcium channel blockers, other anthracyclines increase risk of cardiac toxicity; limit lifetime dose to 400mg/m2. Necrotizing colitis with cytarabine. May increase toxicity of cyclophosphamide, mercaptopurine. May reduce serum digoxin levels. Doxorubicin toxicity increased with high-dose IV progesterone, cyclosporine, streptozocin, and if given after paclitaxel infusion (give doxorubicin dose first). Elimination increased by phenobarbital. May decrease phenytoin levels. Recall pneumonitis with actinomycin and radiation in children. |
| Adverse Reactions |
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Local necrosis if extravasation occurs, myocardial toxicity (immediate or delayed), arrhythmias, leukemia, myelosuppression, hyperuricemia, urine discoloration, alopecia, hyperpigmentation, severe GI upset/ulceration, phlebosclerosis, facial flushing, fever, urticaria, peripheral neuropathy, anaphylaxis. |
| How Supplied |
Vials (10mg, 20mg)—10
Vials (50mg)—1
Soln (5mL, 10mL, 25mL)—10
Soln (100mL)—1 (multidose vial) |
| Additional Resources |
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• Related Prescribing Note |
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