Medicine Information

Doxorin

Name: Doxorin
Brand: Doxorin
Rating: 4.5 (117 reviews)

Tablet200 mgAntineoplastic agent, AnthracyclineATC: L01DB01

Generic Name

Doxorubicin

Manufacturer

Hypothetical Pharma Inc.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
doxorin 200 mg tablet	৳ 6.00	৳ 60.00

Description

Overview of the medicine

Doxorubicin is an anthracycline cytotoxic antibiotic used in the treatment of a wide range of cancers. While typically administered intravenously, this specific formulation is a 200 mg oral tablet designed for certain therapeutic regimens.

Uses & Indications

Breast cancer

Ovarian cancer

Bladder cancer

Small cell lung cancer

Hodgkin's and non-Hodgkin's lymphomas

Acute lymphoblastic leukemia

Dosage

Adults

Dosage is highly individualized based on cancer type, treatment regimen, patient's body surface area, and bone marrow reserve. Typically given as part of a multi-drug regimen, exact oral dosage would be determined by an oncologist.

Elderly

No specific dose adjustments solely based on age, but close monitoring for cardiac and hematologic toxicity is recommended due to potential age-related organ dysfunction.

Renal_impairment

No significant dose reduction needed for mild to moderate renal impairment. For severe impairment (CrCl <10 mL/min), a dose reduction may be considered, but hepatic function is more critical.

How to Take

Take the tablet orally with water, exactly as prescribed by your oncologist. Do not crush, chew, or break the tablet. It may be taken with or without food, but consistency is recommended.

Mechanism of Action

Doxorubicin acts by intercalating into DNA, inhibiting topoisomerase II, and generating free radicals, leading to DNA damage and cell death, particularly in rapidly proliferating cells.

Pharmacokinetics

Onset

Effect onset may vary depending on absorption and cancer type, generally within days to weeks of therapy initiation.

Excretion

Excreted mainly through bile and feces (40-50% unchanged drug in 7 days), with a smaller portion (5-12%) excreted renally.

Half life

Plasma half-life is biphasic or triphasic, with initial phases of 1-3 hours and terminal half-life ranging from 30-70 hours.

Absorption

While intravenous doxorubicin has immediate bioavailability, an oral tablet formulation (like hypothetical Doxorin 200 mg) would be designed for improved but variable absorption, often with low oral bioavailability compared to IV forms.

Metabolism

Extensively metabolized in the liver to active (doxorubicinol) and inactive metabolites. Primarily via aldo-keto reductase.

Side Effects

Contraindications

Hypersensitivity to doxorubicin or other anthracyclines
Severe myocardial insufficiency
Severe liver impairment
Severe bone marrow depression
Previous treatment with maximum cumulative doses of doxorubicin or related anthracyclines

Drug Interactions

Verapamil

May enhance doxorubicin cytotoxicity and increase plasma concentrations.

Cyclosporine

May increase doxorubicin levels and toxicity.

Live vaccines

Avoid due to immunosuppression.

Phenobarbital/Phenytoin

May reduce doxorubicin efficacy by inducing hepatic metabolism.

Other myelosuppressive agents

Increased risk of bone marrow depression.

Storage

Store below 25°C in a cool, dry place. Protect from light and moisture. Keep out of reach of children.

Overdose

Symptoms include severe myelosuppression (leukopenia, thrombocytopenia, anemia), mucositis, and acute cardiotoxicity. Management is supportive, including blood transfusions, antibiotics for infection, and cardiac monitoring.

Pregnancy & Lactation

Pregnancy Category D. Can cause fetal harm. Avoid during pregnancy. Contraindicated during lactation as it is excreted in breast milk and can cause serious adverse effects in breastfed infants.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per pack30 tablets per pack

Shelf Life

24 months from manufacturing date.

Availability

Specialized oncology pharmacies, hospital pharmacies

Approval Status

Approved (for Doxorubicin, specific 200 mg tablet formulation may be niche or experimental)

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Ongoing research is exploring new formulations, delivery methods (including oral), and combinations of Doxorubicin for various cancer types, aiming to improve efficacy and reduce toxicity.

Lab Monitoring

Complete Blood Count (CBC) with differential (before and during treatment)
Liver Function Tests (LFTs)
Renal Function Tests
Echocardiogram or MUGA scan (to assess Left Ventricular Ejection Fraction - LVEF) before and periodically during treatment

Doctor Notes

Strict cardiac monitoring (e.g., LVEF assessment) is crucial, especially as cumulative dose approaches limits.
Closely monitor CBCs due to significant myelosuppression; dose adjustments or delays may be necessary.
Educate patients thoroughly about potential side effects, especially signs of cardiotoxicity or infection.

Patient Guidelines

Take exactly as prescribed and do not alter the dose without consulting your oncologist.
Report any unusual side effects, especially signs of infection (fever, chills) or heart problems (shortness of breath, swelling).
Maintain good oral hygiene to prevent mucositis.
Stay well-hydrated during treatment.

Missed Dose Advice

If you miss a dose, contact your oncologist immediately for advice. Do not take a double dose to make up for a missed one.

Driving Precautions

Doxorubicin can cause fatigue, dizziness, and weakness. Avoid driving or operating heavy machinery if you experience these symptoms.

Lifestyle Advice

Avoid contact with people who have infections, as your immune system will be suppressed.
Use soft toothbrushes and avoid harsh mouthwashes to prevent oral irritation.
Consider fertility counseling before treatment if planning a family in the future.