L-Dox
Generic Name
Doxorubicin Hydrochloride Liposomal Injection
Manufacturer
Generic Manufacturer
Country
Bangladesh / India
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| l dox 50 mg injection | ৳ 23,000.00 | N/A |
Description
Overview of the medicine
Doxorubicin Liposomal is an anthracycline cytotoxic agent indicated for the treatment of various cancers, including Kaposi's Sarcoma, Ovarian Cancer, Breast Cancer, and Multiple Myeloma. The liposomal formulation helps reduce cardiotoxicity and other side effects compared to conventional doxorubicin.
Uses & Indications
Dosage
Adults
Dosage varies by indication and patient's condition. For Kaposi's Sarcoma: 20 mg/m² intravenously every 2-3 weeks. For Ovarian Cancer: 50 mg/m² intravenously every 4 weeks. For Breast Cancer: 50 mg/m² intravenously every 4 weeks. For Multiple Myeloma: 30 mg/m² intravenously on Day 4 of 21-day bortezomib cycle.
Elderly
No specific dose adjustments required based solely on age, but consider age-related decline in organ function. Closely monitor for adverse effects.
Renal_impairment
No dose adjustments required for mild to moderate renal impairment. For severe renal impairment, data is limited, use with caution and monitor.
How to Take
Administer as a slow intravenous infusion over 60 minutes. Do not administer as a bolus injection or by intramuscular or subcutaneous routes. Dilution might be required before infusion.
Mechanism of Action
Doxorubicin works by intercalating into DNA, inhibiting topoisomerase II, and generating free radicals, leading to DNA damage and cell death. The liposomal formulation encapsulates doxorubicin, allowing for prolonged circulation and selective accumulation in tumor tissues, while reducing exposure to normal tissues, particularly the heart.
Pharmacokinetics
Onset
Relatively rapid distribution after IV administration; therapeutic effects become evident over the course of treatment cycles.
Excretion
Primarily excreted via the biliary route (feces), with a smaller portion excreted renally (urine).
Half life
Prolonged terminal half-life of approximately 50-60 hours due to liposomal formulation.
Absorption
Administered intravenously, leading to direct systemic absorption. Liposomal encapsulation significantly alters pharmacokinetic profile compared to conventional doxorubicin.
Metabolism
Metabolized in the liver to doxorubicinol and other metabolites.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any component of the liposomal formulation
- Patients who have experienced severe allergic reactions to previous doxorubicin treatments
- Severe myocardial insufficiency or recent myocardial infarction
Drug Interactions
Warfarin
Potentially increased anticoagulant effect.
Live vaccines
Avoid due to risk of serious infection in immunocompromised patients.
Cardiotoxic agents
Increased risk of cardiotoxicity.
Myelosuppressive agents
Increased risk of severe myelosuppression.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. Diluted solutions should be used immediately or stored for a limited time as per manufacturer's guidelines.
Overdose
Overdose is likely to result in severe myelosuppression and mucositis. Treatment should be supportive, including hospitalization, antibiotics for infections, platelet transfusions, and symptomatic management.
Pregnancy & Lactation
Doxorubicin can cause fetal harm when administered to a pregnant woman. It is not recommended during pregnancy. Women of childbearing potential should use effective contraception during and for 6 months after treatment. It is unknown if doxorubicin is excreted in human milk, but due to potential serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Hypersensitivity to doxorubicin or any component of the liposomal formulation
- Patients who have experienced severe allergic reactions to previous doxorubicin treatments
- Severe myocardial insufficiency or recent myocardial infarction
Drug Interactions
Warfarin
Potentially increased anticoagulant effect.
Live vaccines
Avoid due to risk of serious infection in immunocompromised patients.
Cardiotoxic agents
Increased risk of cardiotoxicity.
Myelosuppressive agents
Increased risk of severe myelosuppression.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. Diluted solutions should be used immediately or stored for a limited time as per manufacturer's guidelines.
Overdose
Overdose is likely to result in severe myelosuppression and mucositis. Treatment should be supportive, including hospitalization, antibiotics for infections, platelet transfusions, and symptomatic management.
Pregnancy & Lactation
Doxorubicin can cause fetal harm when administered to a pregnant woman. It is not recommended during pregnancy. Women of childbearing potential should use effective contraception during and for 6 months after treatment. It is unknown if doxorubicin is excreted in human milk, but due to potential serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years when stored as recommended. Refer to product label for specific expiry date.
Availability
Hospital pharmacies, specialized oncology centers
Approval Status
Approved (for specific indications)
Patent Status
Patent expired for generic formulations
WHO Essential Medicine
YesClinical Trials
Doxorubicin liposomal has undergone extensive clinical trials demonstrating its efficacy and safety profile in various oncology indications, with particular advantages in reducing cardiotoxicity compared to conventional doxorubicin.
Lab Monitoring
- Complete Blood Count (CBC) with differential, before each dose and periodically during treatment.
- Liver Function Tests (LFTs) before initiation and periodically.
- Renal Function Tests (RFTs) before initiation and periodically.
- Cardiac function (ECG, LVEF) before and regularly during treatment due to cardiotoxicity risk.
Doctor Notes
- Careful monitoring of cardiac function (LVEF) is essential before and throughout treatment, especially in patients with pre-existing cardiac disease or cumulative anthracycline doses.
- Monitor complete blood counts frequently due to myelosuppression risk; dose adjustments or delays may be necessary.
- Manage infusion-related reactions symptomatically; premedication may be considered.
- Extravasation should be managed promptly and aggressively to prevent severe tissue damage.
Patient Guidelines
- Adhere strictly to the prescribed dosage and administration schedule.
- Report any unusual side effects, especially fever, chills, infection signs, or shortness of breath, immediately to your doctor.
- Avoid contact with people who have infections while undergoing treatment.
- Do not receive live vaccines without consulting your doctor.
Missed Dose Advice
If a dose is missed, contact your doctor immediately to reschedule. Do not double the dose to compensate for a missed one.
Driving Precautions
This medicine may cause dizziness, fatigue, or visual disturbances. Patients should be cautioned about driving or operating machinery until they are reasonably certain that the medicine does not adversely affect their ability to perform such activities.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Eat a balanced diet as tolerated to support overall health.
- Practice good oral hygiene to prevent mouth sores.
- Avoid activities that may lead to injury or bleeding due to myelosuppression.
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