Liposomal Doxorubicin (Generic Name)

Other Names: Liposomal Adriamycin, Doxil®

About This Drug

Liposomal doxorubicin is used to treat cancer. This drug is given intravenously (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. Bone marrow depression usually occurs five to seven days after the drug is given and may increase your risk of infection, fatigue, and bleeding.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Nausea and vomiting
  • Mild hair loss. You may notice hair thinning several days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is complete.
  • Redness, swelling, pain, and possibly peeling of skin on the hands and feet or on other skin pressure areas
  • Weakness
  • Back pain
  • Diarrhea or constipation
  • Swelling (fluid retention) in the legs, ankles, and/or feet.
  • Headache

Possible Side Effects (Less Common) 

  • A reaction to this drug during the IV treatment is rare. If patients have a reaction, it is usually during the first IV treatment. Signs of a reaction are shortness of breath, flushing, facial swelling, headaches, chills, back pain, tightness in the chest and throat, and low blood pressure.
  • This medication can cause skin and tissue irritation. You may have redness, pain, warmth, or swelling at the IV site. This irritation occurs if the drug leaks out of the vein and into surrounding tissue.
  • This drug may have effects on the heart. It may weaken the heart and decrease heart function. Your heart function will be checked as needed.
  • Confusion
  • Depression
  • Insomnia
  • Darkening of the skin or fingernails
  • Changes to your sense of taste
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function. Your blood work will be monitored by your doctor. Changes in your liver function. Your doctor will monitor your liver function as needed.
  • Joint and muscle pain
  • Eye irritation. You may have watery eyes. Your eyes and lids may become red and painful. You could contract an infection of your eye known as conjunctivitis.
  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.
  •    -  Be careful when cooking, walking, and handling sharp objects and hot liquids.  

Sexual Problems and Reproduction Concerns

In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.

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.  Ask your doctor or nurse about effective birth control methods.

Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 

Breast Feeding Warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.

Women may experience signs of menopause like vaginal dryness or itching.   Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • To lessen the chance that you will have skin reactions, avoid pressure on the skin for at least three days after each treatment.
  • Do not use tape on your skin because it can worsen any rashes, blisters, and other skin reactions. Tape may also leave a brown mark.
  • Avoid tight clothing to reduce pressure on your skin. For example, a tight bra or waistband can be a source of pressure. Rings and other jewelry are usually not a problem.
  • Wear shoes that fit well. Do not wear shoes that pinch or rub, especially in the bunion area or on top of the toes.
  • Avoid aerobic exercises, power walking, and jumping. Do not dig, prune, or do other types of strenuous gardening.
  • Do not chop hard food, such as carrots, or use a garlic press.
  • Do not lean on your elbows.
  • Avoid hot water on the skin.
  • Do not put anything on reddened skin areas, unless your doctor or nurse says you may.
  • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated. 
  • 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 sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Ask your doctor or nurse about medication that is available to help prevent or lessen nausea, vomiting, diarrhea, headache, nasal congestion and/or sinus symptoms.
  • During the IV infusion, if you experience pain, redness, or swelling at the site of the IV infusion, please tell your nurse immediately.
  • Speak with your nurse about obtaining 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 undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and  skin and nail care.

Food and Drug Interactions

 There are no known interactions of Liposomal Doxorubicin with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

Allergic Reaction

  • Serious allergic reactions including anaphylaxis (rare).  Tell your doctor or nurse immediately if you have any of the following symptoms during the time you are receiving this drug or shortly after:
         -Difficulty catching your breath
         -Feeling like your tongue or throat are swelling
         -Feeling your heart beat rapidly (palpitations)
         -Dizziness or lightheadedness
         -Flushing/itching/rash/hives

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than three times in one day
  • Redness, pain, warmth, or swelling at the IV site
  • Chest pain
  • Rapid or irregular heartbeat (palpitations)
  • Swelling of ankles
  • Difficulty catching your breath
  • Dizziness or lightheadedness

Notify your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Nausea unrelieved by prescribed medication
  • Extreme tiredness that interferes with normal activities
  • Redness, swelling, pain, or peeling of skin
  • Joint or muscle pain that is interfering with daily activities

Revised November 2011 

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