Doxorubicin Phares
Generic Name
Doxorubicin
Manufacturer
Phares Pharmaceutical
Country
Unknown
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| doxorubicin phares 2 mg injection | ৳ 950.00 | N/A |
Description
Overview of the medicine
Doxorubicin is an anthracycline cytotoxic antibiotic used in the treatment of various cancers, including solid tumors and hematologic malignancies. It works by interfering with DNA and inhibiting topoisomerase II.
Uses & Indications
Dosage
Adults
Highly individualized based on cancer type, BSA, and concomitant therapy. Typical IV dose is 60-75 mg/m² every 3 weeks, or 20 mg/m² weekly.
Elderly
Increased risk of cardiotoxicity; dose reduction or careful monitoring may be necessary.
Renal_impairment
No specific dose adjustment for mild to moderate renal impairment; caution in severe impairment. Monitor for toxicity.
Hepatic_impairment
Significant dose reduction required based on bilirubin levels. E.g., for bilirubin 1.2-3 mg/dL, give 50% of normal dose; for >3 mg/dL, give 25% of normal dose.
How to Take
Administered by slow intravenous infusion (over 3-5 minutes or longer) by experienced healthcare professionals. Care must be taken to avoid extravasation.
Mechanism of Action
Doxorubicin intercalates into DNA, inhibits topoisomerase II, and generates free radicals, leading to DNA damage and ultimately apoptosis of cancer cells.
Pharmacokinetics
Onset
Rapid distribution, effects on cell cycle can be seen within minutes to hours.
Excretion
Mainly excreted via bile/feces (40-50% in 7 days); a small amount (5-12%) is excreted in urine.
Half life
Biphasic elimination with an initial rapid phase (approx. 5 minutes) and a terminal phase of 20-48 hours.
Absorption
Administered intravenously, resulting in complete bioavailability.
Metabolism
Primarily metabolized in the liver to the active metabolite doxorubicinol.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin, other anthracyclines, or anthracyclin-diones.
- Severe myocardial insufficiency, recent myocardial infarction, or severe persistent arrhythmias.
- Previous therapy with maximum cumulative doses of doxorubicin or other anthracyclines.
- Severe hepatic impairment.
- Severe myelosuppression or persistent infections.
Drug Interactions
Live vaccines
Avoid due to immunosuppression.
Phenobarbital, Phenytoin
May reduce doxorubicin efficacy by inducing hepatic enzymes.
Other myelosuppressive agents
Increased risk of hematologic toxicity.
Cyclosporine, Paclitaxel, Verapamil
May increase plasma concentrations and/or enhance toxicity of doxorubicin.
Cardiac active agents (e.g., trastuzumab)
May increase cardiotoxicity risk.
Storage
Store refrigerated (2°C to 8°C / 36°F to 46°F), protect from light. Do not freeze.
Overdose
Acute overdose leads to severe myelosuppression, cardiotoxicity, and mucositis. Treatment is symptomatic and supportive, including transfusions, anti-infectives, and cardiac support.
Pregnancy & Lactation
Pregnancy Category D. Doxorubicin can cause fetal harm when administered to a pregnant woman. It is not recommended during pregnancy or breastfeeding. Women of childbearing potential should use effective contraception.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin, other anthracyclines, or anthracyclin-diones.
- Severe myocardial insufficiency, recent myocardial infarction, or severe persistent arrhythmias.
- Previous therapy with maximum cumulative doses of doxorubicin or other anthracyclines.
- Severe hepatic impairment.
- Severe myelosuppression or persistent infections.
Drug Interactions
Live vaccines
Avoid due to immunosuppression.
Phenobarbital, Phenytoin
May reduce doxorubicin efficacy by inducing hepatic enzymes.
Other myelosuppressive agents
Increased risk of hematologic toxicity.
Cyclosporine, Paclitaxel, Verapamil
May increase plasma concentrations and/or enhance toxicity of doxorubicin.
Cardiac active agents (e.g., trastuzumab)
May increase cardiotoxicity risk.
Storage
Store refrigerated (2°C to 8°C / 36°F to 46°F), protect from light. Do not freeze.
Overdose
Acute overdose leads to severe myelosuppression, cardiotoxicity, and mucositis. Treatment is symptomatic and supportive, including transfusions, anti-infectives, and cardiac support.
Pregnancy & Lactation
Pregnancy Category D. Doxorubicin can cause fetal harm when administered to a pregnant woman. It is not recommended during pregnancy or breastfeeding. Women of childbearing potential should use effective contraception.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Varies by manufacturer and formulation; typically 2-4 years when stored correctly. Refer to the product label.
Availability
Hospitals, specialized cancer treatment centers
Approval Status
Approved
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Doxorubicin has been extensively studied for decades. Ongoing research includes studies on new liposomal formulations, combination therapies, and strategies to mitigate cardiotoxicity.
Lab Monitoring
- Complete Blood Count (CBC) with differential before each cycle and periodically.
- Cardiac function tests (ECG, ECHO, MUGA scan) to monitor for cardiotoxicity, especially before starting therapy and at regular intervals during treatment.
- Liver function tests (LFTs) before each dose to adjust dosage.
- Renal function tests (RFTs) for baseline assessment.
Doctor Notes
- Closely monitor patient for signs of cardiotoxicity (e.g., reduced LVEF) and myelosuppression (CBC with differential) before and during treatment.
- Careful dose adjustment is crucial in patients with hepatic impairment.
- Strict precautions must be taken to prevent extravasation; immediate management protocols should be in place if extravasation occurs.
- Maintain strict cumulative dose limits to minimize irreversible cardiac damage.
Patient Guidelines
- Report any fever, unusual bleeding or bruising, or signs of infection (e.g., sore throat) immediately.
- Maintain good oral hygiene to minimize stomatitis.
- Be prepared for temporary hair loss (alopecia).
- Understand the risks of cardiac toxicity and other serious side effects, and report any symptoms promptly.
Missed Dose Advice
As doxorubicin is administered under strict medical supervision in a hospital setting, a missed dose would be managed by the treating physician according to the patient's chemotherapy schedule.
Driving Precautions
Doxorubicin may cause fatigue, dizziness, or visual disturbances. Patients should be advised to avoid driving or operating machinery if they experience these effects.
Lifestyle Advice
- Avoid close contact with people who are sick or have infections, as your immune system will be weakened.
- Discuss family planning and fertility preservation options with your doctor before starting treatment, as doxorubicin can affect fertility.
- Maintain adequate hydration by drinking plenty of fluids.
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