Dorubin
Generic Name
Doxorubicin Hydrochloride
Manufacturer
Example Pharma
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dorubin 20 mg injection | ৳ 500.00 | N/A |
Description
Overview of the medicine
Doxorubicin is an anthracycline cytotoxic antibiotic used to treat various cancers, including leukemia, lymphoma, breast cancer, and ovarian cancer. It works by interfering with DNA and RNA synthesis.
Uses & Indications
Dosage
Adults
Typically 60-75 mg/m² IV as a single dose every 21 days, or 20 mg/m² weekly. Cumulative dose limits apply due to cardiotoxicity.
Elderly
Lower doses or extended intervals may be considered due to age-related organ function decline.
Renal_impairment
No specific dose adjustment for mild to moderate renal impairment, but caution is advised. Severe impairment requires dose reduction.
How to Take
Administered intravenously, usually by slow infusion over 3-10 minutes (for bolus) or several hours (for infusion). Avoid extravasation.
Mechanism of Action
Intercalates into DNA, inhibiting topoisomerase II, generating free radicals, and causing DNA damage, ultimately leading to apoptosis of cancer cells.
Pharmacokinetics
Onset
Rapid distribution; cytotoxic effects occur over days to weeks.
Excretion
Primarily biliary/fecal (40-50%), with a small amount excreted renally.
Half life
Biphasic elimination, terminal half-life of 20-48 hours.
Absorption
Administered intravenously, thus bioavailability is 100%.
Metabolism
Primarily hepatic (aldoketo reductase), forming doxorubicinol (an active metabolite).
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or other anthracyclines
- Marked myelosuppression
- Severe cardiac impairment
- Previous maximum cumulative dose of doxorubicin or related anthracyclines
- Pregnancy and lactation
Drug Interactions
Verapamil
Increased doxorubicin concentrations
Cimetidine
May increase doxorubicin plasma levels
Paclitaxel
Altered pharmacokinetics of doxorubicin
Live vaccines
Increased risk of infection in immunosuppressed patients
Cyclophosphamide
Increased cardiotoxicity
Storage
Store unconstituted vials at refrigerated temperatures (2°C-8°C). Protect from light. Reconstituted solution should be used within 24 hours if refrigerated, or shorter if at room temperature.
Overdose
Acute overdose leads to severe myelosuppression, gastrointestinal toxicity, and cardiac toxicity. Management is symptomatic and supportive, including blood transfusions, antibiotics, and granulocyte colony-stimulating factors.
Pregnancy & Lactation
Category D in pregnancy (evidence of fetal risk). Advise effective contraception during and for an adequate period after treatment. Not recommended during lactation as it is excreted in breast milk and can cause serious adverse reactions in infants.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or other anthracyclines
- Marked myelosuppression
- Severe cardiac impairment
- Previous maximum cumulative dose of doxorubicin or related anthracyclines
- Pregnancy and lactation
Drug Interactions
Verapamil
Increased doxorubicin concentrations
Cimetidine
May increase doxorubicin plasma levels
Paclitaxel
Altered pharmacokinetics of doxorubicin
Live vaccines
Increased risk of infection in immunosuppressed patients
Cyclophosphamide
Increased cardiotoxicity
Storage
Store unconstituted vials at refrigerated temperatures (2°C-8°C). Protect from light. Reconstituted solution should be used within 24 hours if refrigerated, or shorter if at room temperature.
Overdose
Acute overdose leads to severe myelosuppression, gastrointestinal toxicity, and cardiac toxicity. Management is symptomatic and supportive, including blood transfusions, antibiotics, and granulocyte colony-stimulating factors.
Pregnancy & Lactation
Category D in pregnancy (evidence of fetal risk). Advise effective contraception during and for an adequate period after treatment. Not recommended during lactation as it is excreted in breast milk and can cause serious adverse reactions in infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years for unconstituted vials. Check specific product labeling for exact details.
Availability
Hospitals, specialized oncology centers
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for various cancers, often as part of combination chemotherapy regimens. Ongoing research explores new formulations and treatment combinations.
Lab Monitoring
- Complete blood counts (CBC) before each cycle
- Liver function tests (LFTs)
- Renal function tests
- Echocardiogram or MUGA scan to monitor cardiac function (baseline and periodically)
- Serum uric acid levels
Doctor Notes
- Careful cardiac monitoring (ECHO/MUGA) is crucial, especially with higher cumulative doses and in patients with pre-existing cardiac conditions.
- Strict adherence to administration guidelines to prevent extravasation; prompt management if it occurs.
- Monitor CBCs frequently due to myelosuppression risk, and manage proactively with supportive care.
- Assess for prior anthracycline exposure before starting treatment.
Patient Guidelines
- Report any signs of infection (fever, chills) immediately.
- Report any pain, burning, or swelling at the injection site.
- Stay well hydrated.
- Use effective birth control during treatment and for a period after.
- Avoid contact with people who are sick or have infections.
Missed Dose Advice
Contact the oncology team immediately. Do not self-administer or adjust doses.
Driving Precautions
May cause fatigue, nausea, or dizziness. Avoid driving or operating heavy machinery if experiencing these symptoms.
Lifestyle Advice
- Avoid crowded places to reduce infection risk.
- Maintain good oral hygiene to prevent mucositis.
- Discuss fertility preservation options before starting treatment.
- Eat small, frequent meals to manage nausea.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.