Liposomal Doxorubicin (Generic Name)

Other Names: Liposomal Adriamycin, Doxil®

About This Drug

Liposomal doxorubicin is used to treat cancer. This drug is given in the vein (IV).

Possible Side Effects (More Common) 

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment. Medicines are available to stop or lessen these side effects.
  • Hair loss. You may notice your hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
  • Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Weakness that interferes with your daily activities
  • Loose bowel movements (diarrhea) that may last for a few days
  • Constipation (not able to move bowels)
  • Swelling of your legs, ankles, and/or feet.
  • Headache

Possible Side Effects (Less Common) 

  • Flushing, itching, rash, and/or hives
  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
  • Effects on the heart: This drug can weaken the heart and lower heart function. Your heart function will be checked as needed. You may have trouble catching your breath, mainly during activities. You may also have trouble breathing while lying down, and have swelling in your ankles.
  • Mood changes such as depression or feeling nervous
  • Feeling tired
  • Darkening of the skin or nails 
  • Changes in the way food and drinks taste
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function. Your blood work will be checked by your doctor.
  • General weakness and discomfort (aches and pains)
  • Eye irritation. You may have watery eyes. Your eyes and eyelids may become red and painful.

Allergic Reactions

Allergic reactions to this drug are rare, but may happen in some patients.  While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly  or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded

Treating Side Effects

  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • Talk with your nurse about getting a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information  about the “ Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care. 
  • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • While you are getting this medicine in your vein, tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion

Food and Drug Interactions

There are no known interactions of liposomal doxorubicin with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help. 

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times in a day
  • Redness, pain, warmth, or swelling at the IV site
  • Chest pain
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Swelling of legs, ankles, or feet
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded. 

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Nausea that is not relieved by prescribed medicines
  • Fatigue that interferes with your normal activities
  • Painful, red, or swollen areas on your hands or feet.
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions

Sexual Problems and Reproduction Concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking. 
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to  their doctor  about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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