L-Dox
Generic Name
Liposomal Doxorubicin Hydrochloride
Manufacturer
Various manufacturers (e.g., Sun Pharmaceutical, Dr. Reddy's)
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| l dox 20 mg injection | ৳ 12,000.00 | N/A |
Description
Overview of the medicine
L-Dox 20 mg Injection contains liposomal doxorubicin hydrochloride, an anthracycline cytotoxic antibiotic. It is used in the treatment of various cancers, including Kaposi's sarcoma, ovarian cancer, and multiple myeloma, especially when other treatments have failed or are not suitable.
Uses & Indications
Dosage
Adults
AIDS-KS: 20 mg/m² IV every 2-3 weeks. Ovarian cancer: 50 mg/m² IV every 4 weeks. Multiple myeloma: 30 mg/m² IV (on day 4 of bortezomib cycle). Doses vary by indication and patient condition.
Elderly
No specific dose adjustment based solely on age, but close monitoring for adverse effects is recommended.
Renal_impairment
Requires careful monitoring; no specific dose adjustment needed for mild to moderate impairment, but caution for severe impairment.
How to Take
Administered as an intravenous infusion over 30-90 minutes, depending on the dose, after dilution with 5% Dextrose Injection. Must be administered by a healthcare professional experienced in oncology.
Mechanism of Action
Doxorubicin intercalates into DNA, inhibiting topoisomerase II, leading to DNA strand breaks and inhibition of nucleic acid synthesis. The liposomal formulation helps to reduce cardiotoxicity and alters pharmacokinetics, allowing for preferential accumulation in tumor tissues.
Pharmacokinetics
Onset
Not immediate, anti-cancer effects develop over treatment course.
Excretion
Primarily via bile and feces. Renal excretion is minor.
Half life
Terminal half-life is significantly longer than conventional doxorubicin, approximately 50-60 hours.
Absorption
Administered intravenously, hence 100% bioavailability. Liposomal formulation prolongs circulation.
Metabolism
Minimal metabolism of intact liposomal doxorubicin. Doxorubicinol, an active metabolite, is formed from released doxorubicin.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any components of the formulation
- Patients with previous severe myocardial damage
- In AIDS-KS patients with concomitant opportunistic infections requiring intensive anti-infective treatment
Drug Interactions
Live vaccines
Avoid due to immunosuppression.
Other myelosuppressive agents
Increased risk of myelosuppression.
Cyclosporine, Tacrolimus, Verapamil
May increase doxorubicin levels/effects.
Cardiotoxic agents (e.g., trastuzumab)
Increased risk of cardiotoxicity.
Storage
Store refrigerated between 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. After dilution, use immediately or within 24 hours if refrigerated.
Overdose
Symptoms of overdose include severe myelosuppression, mucositis, and cardiotoxicity. Management is supportive, including blood transfusions, antibiotics for infections, and symptomatic treatment. No specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Should be avoided during pregnancy. Not recommended during breastfeeding due to potential for serious adverse reactions in the infant.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any components of the formulation
- Patients with previous severe myocardial damage
- In AIDS-KS patients with concomitant opportunistic infections requiring intensive anti-infective treatment
Drug Interactions
Live vaccines
Avoid due to immunosuppression.
Other myelosuppressive agents
Increased risk of myelosuppression.
Cyclosporine, Tacrolimus, Verapamil
May increase doxorubicin levels/effects.
Cardiotoxic agents (e.g., trastuzumab)
Increased risk of cardiotoxicity.
Storage
Store refrigerated between 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. After dilution, use immediately or within 24 hours if refrigerated.
Overdose
Symptoms of overdose include severe myelosuppression, mucositis, and cardiotoxicity. Management is supportive, including blood transfusions, antibiotics for infections, and symptomatic treatment. No specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Should be avoided during pregnancy. Not recommended during breastfeeding due to potential for serious adverse reactions in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 months, store according to manufacturer instructions.
Availability
Hospitals, specialized oncology clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA)
Patent Status
Generics available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated efficacy and safety in indicated cancers, with a reduced risk of cardiotoxicity compared to conventional doxorubicin.
Lab Monitoring
- Complete Blood Count (CBC) with differential (before each dose and periodically)
- Liver function tests (LFTs)
- Renal function tests
- Cardiac function monitoring (e.g., echocardiogram, MUGA scan) before and during treatment.
Doctor Notes
- Closely monitor cardiac function (LVEF) before and during treatment.
- Manage myelosuppression with appropriate supportive care.
- Monitor for signs of hand-foot syndrome and manage proactively.
- Infusion reactions are common and often manageable by slowing infusion rate or pre-medication.
Patient Guidelines
- Report any fever, bleeding, or unusual bruising immediately.
- Inform your doctor about any pain, redness, or swelling at the injection site.
- Stay hydrated and maintain good oral hygiene to manage mucositis.
- Avoid live vaccines during treatment.
Missed Dose Advice
Contact your doctor immediately if a dose is missed. Do not double the dose.
Driving Precautions
May cause fatigue, dizziness, or visual disturbances. Advise caution when driving or operating machinery.
Lifestyle Advice
- Follow a balanced diet and engage in light exercise if tolerated.
- Avoid crowded places to reduce infection risk.
- Use soft toothbrushes and gentle mouthwashes to prevent oral irritation.
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International brand names for this medicine. Click a brand to search for detailed information.
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