Dobixin
Generic Name
Doxorubicin
Manufacturer
ACI Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dobixin 2 mg injection | ৳ 275.00 | N/A |
Description
Overview of the medicine
Dobixin (Doxorubicin) is an anthracycline cytotoxic antibiotic used in the treatment of various cancers, including breast cancer, lymphomas, leukemias, and several solid tumors. It works by interfering with cancer cell DNA.
Uses & Indications
Dosage
Adults
Highly individualized based on cancer type, patient condition, and body surface area (BSA). Typical single agent dose: 60-75 mg/m² IV every 21 days.
Elderly
Dose reduction may be necessary due to age-related decline in organ function. Careful monitoring is advised.
Renal_impairment
No specific dose adjustment for mild to moderate renal impairment, but caution is advised. Not significantly eliminated by kidneys.
How to Take
Administered by slow intravenous infusion (usually over 10-15 minutes to prevent extravasation or longer for specific regimens). A central venous line is often preferred to minimize extravasation risk. Should not be given intramuscularly or subcutaneously.
Mechanism of Action
Doxorubicin acts by intercalating into DNA, inhibiting topoisomerase II, and generating free radicals, all of which lead to DNA damage and inhibition of DNA and RNA synthesis, ultimately causing apoptosis in cancer cells.
Pharmacokinetics
Onset
Rapid onset of action, typically within minutes to hours of administration.
Excretion
Excreted primarily via bile (major route) and feces, with minor renal excretion.
Half life
Triphasic elimination, with a terminal half-life of approximately 30-40 hours.
Absorption
Administered intravenously, hence 100% bioavailability.
Metabolism
Extensively metabolized in the liver to active and inactive metabolites, primarily doxorubicinol.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any component of the formulation
- Severe myocardial insufficiency or recent myocardial infarction
- Severe myelosuppression (unless the benefit outweighs the risk)
- Previous treatment with maximum cumulative doses of doxorubicin or other anthracyclines
- Pregnancy and lactation
Drug Interactions
Paclitaxel
Concurrent administration may alter doxorubicin's pharmacokinetics, potentially increasing cardiotoxicity. Administer doxorubicin first.
Trastuzumab
Concomitant use with trastuzumab can significantly increase the risk of cardiotoxicity.
Cyclosporine
May increase plasma concentrations of doxorubicin and doxorubicinol, leading to enhanced toxicity. Dose adjustment may be necessary.
Live vaccines
Avoid use with live vaccines due to immunosuppression.
Phenobarbital/Phenytoin
May increase doxorubicin metabolism and decrease efficacy.
Storage
Store intact vials refrigerated at 2-8°C (36-46°F). Protect from light. Do not freeze. Reconstituted solutions should be used within 24 hours.
Overdose
Acute overdose results in severe myelosuppression, mucositis, and gastrointestinal toxicity. Management is primarily supportive, including transfusions, anti-infectives, and aggressive hydration. Cardiac monitoring is crucial.
Pregnancy & Lactation
Pregnancy Category D. Doxorubicin can cause fetal harm when administered to pregnant women. Advise women of reproductive potential to use effective contraception. It is contraindicated during lactation due to potential harm to the infant.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any component of the formulation
- Severe myocardial insufficiency or recent myocardial infarction
- Severe myelosuppression (unless the benefit outweighs the risk)
- Previous treatment with maximum cumulative doses of doxorubicin or other anthracyclines
- Pregnancy and lactation
Drug Interactions
Paclitaxel
Concurrent administration may alter doxorubicin's pharmacokinetics, potentially increasing cardiotoxicity. Administer doxorubicin first.
Trastuzumab
Concomitant use with trastuzumab can significantly increase the risk of cardiotoxicity.
Cyclosporine
May increase plasma concentrations of doxorubicin and doxorubicinol, leading to enhanced toxicity. Dose adjustment may be necessary.
Live vaccines
Avoid use with live vaccines due to immunosuppression.
Phenobarbital/Phenytoin
May increase doxorubicin metabolism and decrease efficacy.
Storage
Store intact vials refrigerated at 2-8°C (36-46°F). Protect from light. Do not freeze. Reconstituted solutions should be used within 24 hours.
Overdose
Acute overdose results in severe myelosuppression, mucositis, and gastrointestinal toxicity. Management is primarily supportive, including transfusions, anti-infectives, and aggressive hydration. Cardiac monitoring is crucial.
Pregnancy & Lactation
Pregnancy Category D. Doxorubicin can cause fetal harm when administered to pregnant women. Advise women of reproductive potential to use effective contraception. It is contraindicated during lactation due to potential harm to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 4 years from the date of manufacture, when stored under recommended conditions.
Availability
Hospitals, oncology centers, specialized pharmacies
Approval Status
Approved (FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Doxorubicin continues to be investigated in various clinical trials, often in combination with novel targeted therapies or immunotherapies, to improve efficacy and reduce toxicity across a range of cancers.
Lab Monitoring
- Complete Blood Count (CBC) with differential before each cycle and periodically during treatment
- Cardiac function tests (e.g., Echocardiogram, MUGA scan) to assess Left Ventricular Ejection Fraction (LVEF) before and during treatment
- Liver function tests (bilirubin, AST, ALT) before each cycle
- Renal function tests (creatinine, BUN)
Doctor Notes
- Strict cardiac monitoring (baseline and periodic LVEF assessment) is essential due to the risk of dose-dependent, cumulative cardiotoxicity.
- Adhere to maximum cumulative lifetime dose limits for doxorubicin.
- Careful administration is crucial to avoid extravasation; manage extravasation immediately if it occurs.
- Monitor CBC frequently during treatment due to significant myelosuppression.
Patient Guidelines
- Report any signs of infection (fever, chills), bleeding, or bruising immediately.
- Report any shortness of breath, swelling of feet/ankles, or unusual fatigue, which could indicate heart problems.
- Maintain good oral hygiene to prevent mucositis.
- Stay well-hydrated.
- Avoid contact with people who are sick.
Missed Dose Advice
If a dose is missed, contact your oncologist or healthcare provider immediately to reschedule. Do not double the dose.
Driving Precautions
Doxorubicin can cause fatigue, weakness, and nausea, which may impair your ability to drive or operate machinery. Exercise caution until you know how the medication affects you.
Lifestyle Advice
- Avoid vigorous activities and contact sports due to increased risk of bleeding or bruising.
- Manage fatigue by prioritizing rest and light activities.
- Maintain a balanced diet as tolerated.
- Practice gentle personal hygiene.
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