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Brand names:

Adriamycin®, Doxil®, Lipodox 50

Other names:

Liposomal doxorubicin, doxorubicin lipid complex, hydroxydaunomycin hydrochloride, doxorubicin hydrochloride

Often used for:

Leukemia, lymphoma, Wilms tumor, neuroblastoma, sarcomas, other solid tumors

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What is doxorubicin?

Doxorubicin is a type of chemotherapy. It works by slowing or stopping the growth of cells. It is usually used in combination with other medicines. 

Doxorubicin can cause serious heart problems. These problems can occur during therapy or months to years later. Tell your care team right away if your child has a cough, a heartbeat that is not normal (such as too fast or too slow), swelling in the arms or legs, shortness of breath, sudden weight gain, tiredness, or weakness. The care team may order tests before and during treatment to see if the heart is working well enough to receive doxorubicin. Your child may get a medicine called dexrazoxane to help prevent heart problems caused by doxorubicin. 

Your child will have regular blood draws to check blood counts and liver and kidney function. This medicine can cause heart damage, so your child’s heart function will be closely monitored. 

Doxorubicin can cause tissue damage or blisters if it leaks from the vein. Tell your care team if there is skin irritation or burning at the IV site. 

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Given as a liquid into a vein by IV or injection

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Possible side effects

  • Red or orange color of urine, sweat, and tears
  • Mouth sores
  • Heart problems
  • Change in skin color at the site of radiation treatment
  • Hair loss
  • Nausea
  • Vomiting
  • Loss of appetite
  • Diarrhea
  • Fatigue or weakness
  • Dehydration
  • Abdominal (belly) pain
  • Eye pain or irritation
  • Change in growth or color of nails
  • Low blood counts, usually after 10-14 days taking doxorubicin
  • Liver problems
  • Change in the normal menstrual cycle
  • Fertility problems (These may be temporary or long-term)
  • Skin irritation at the IV site

Not all patients who take doxorubicin will have these side effects. Common side effects are in bold, but there may be others. Please report all symptoms or side effects to your doctor or pharmacist.

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Possible long-term or late effects

Doxorubicin may cause medical problems that continue or develop months or years after therapy ends. These may include:

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Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist.

  • Doxorubicin is a clear, red or orange color. It can cause urine, sweat, and tears to change color for a few days after a dose is given.
  • Doxorubicin can cause heart damage. Your care team will monitor your child’s heart function. Watch for signs of heart problems. These can occur at any time during or after treatment.
  • Your child may get a medicine called dexrazoxane to help prevent or treat heart problems or tissue damage caused by doxorubicin.
  • Your care team may prescribe medicine to reduce nausea and vomiting. 
  • This medicine can weaken the immune system and increase the risk of infection. Wash hands often, keep patient areas clean, and avoid contact with people who are sick.
  • This medicine may cause mouth sores. Good dental hygiene, a soft food diet, lip care, and ice therapy can help prevent and treat mouth sores. Your care team may prescribe a mouth rinse to keep the mouth clean and help with irritation.
  • Make sure your child drinks plenty of liquids. 
  • While taking this medicine, your child should not eat grapefruit or Seville (bitter) oranges or drink juice or beverages containing grapefruit or Seville orange.  
  • Certain medicines can interact with doxorubicin. These include itraconazole, ketoconazole, and voriconazole. Tell your doctor and pharmacist about all medicines your child is taking.
  • Doxorubicin can affect your child’s ability to get pregnant or father a child. Talk to your doctor about the risk of fertility problems and options for protecting fertility.
  • Sexually active patients should talk to their care team about sexual health during treatment. Take steps to prevent pregnancy while taking doxorubicin and for 6 months after completion of therapy.
  • Patients should tell their doctor if they are pregnant or breastfeeding. 
  • Take steps to protect caregivers and family members from drug hazards. Follow instructions for chemotherapy safety. Avoid contact with patient body fluids, which can contain the drug for 48 hours after it is given.