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Doxorubicin (Adriamycin, Rubex, Doxil)  

 

Doxorubicin is a chemotherapy drug belonging to antineoplastic medication family. It is used to treat different types of cancer including prostate cancer. This anti-cancer medication works by obstructing the growth of cancer cells and slows their development in the body. Although this drug is used as medication for many types of cancers, it can be more effective in treating certain malignant tumors.  

 

Indications: the main variety of cancers that Doxorubicin is used to treat include cervical cancer, endometrial cancer, prostate cancer, liver cancer, ovarian cancer, Carcinoid tumors, multiple myeloma, pancreatic cancer, cancer of the Oesophagus. This drug is also indicated in few types of cancers that occur in children (Retinoblastoma, hepatoblastoma), Adrenal cortex cancers, and in the treatment of the symptoms of auto immune deficiency syndrome (AIDS).  

 

Dosage: Doxorubicin is administered only in hospital by specialists in oncology, hematology, or by well trained and experienced nurses. Special monitoring is required at the time of the treatment when using this drug. Doxorubicin is injected into a vein over 3-10 minutes. In special cases, the medication can be taken by continuous combination over a period of 48 to 96 hours. High doses of Doxorubicin may enhance toxic effects, causing heart problems and severe aplitic anaemia. Blood transfusions or other supportive measures are included in the treatment for an overdose of the drug. 

 

Contraindications: Doxorubicin may face contraindications in following conditions:   

  • In case of pregnancy or lactating mothers 
  • If the patient is suffering from kidney failure or other related problems 
  • If the patient has taken any vaccination for measles or flu 
  • If the patient has any heart disease or having low blood counts 
  • If patient is allergic to this drug or any of its components 

Mechanism of Action (MOA): Growth of the cancer cells are prohibited by reducing the amalgamation of DNA and RNA, a genetic increase for the reproduction and development of the cancer cells. This drug interacts with DNA and inhibits the macromolecular biosynthesis. It also stabilizes the topoisomerase II complex thus preventing the replication of DNA.  

 

Interactions: Doxorubicin is a new preparation of liposomal doxorubicin which is, supposedly, the same to Adriamycin in effectiveness. It delivers lesser amount of toxicity to the normal tissues of the rest of the body. Association of Doxorubicin with certain drugs can modify its curative effects and increase the risk of developing side effects. Ganciclovir, Amphotericin B, Azathioprine, Digoxin, Plicamycin, Amiodarone, Barbiturates (depressant drug), Cimetidiine, Colchicines (Alkylating agent used for various types of cancers) are some of the drugs used in interaction with Doxorubicin. In rare cases, non-cancerous cells are damaged with the combined use of the drugs.    

 

Side Effects: The medication is generally associated with side effects which can be minor or severe. Over dosing Doxorubicin may lead to enhancement of its toxic effects. Intake of its high doses may cause serious heart problems or serious aplastic anemia (inability of bone marrow to produce adequate new cells) within two weeks. 

 

Some times its overdosing proves to be so fatal that it can lead to heart failure even after 6 months. In such cases doctor must be consulted at earliest for instituting of relevant supportive measures like blood transfusion, medication, other treatment or even hospital stay.