Precautions and Warnings With Doxorubicin

Some precautions and warnings with doxorubicin to be aware of include potential drug interactions, the safety of taking the drug while pregnant or breastfeeding, and the increased risk of developing congestive heart failure. You should not take doxorubicin if you have health conditions such as severe liver disease, severe heart failure, or a severe arrhythmia.

 

Doxorubicin: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking doxorubicin hydrochloride (Adriamycin®, Doxil®) if you have:
 
  • Congestive heart failure (CHF), an irregular heart rhythm (arrhythmia), or other heart problems
  • A history of low levels of white blood cells in the blood (known medically as neutropenia)
  • Any infection
  • Liver disease, including liver failure or cirrhosis
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Doxorubicin

Some warnings and precautions to be aware of prior to taking doxorubicin include the following:
 
  • Doxorubicin can increase your risk of congestive heart failure (CHF), arrhythmias, or other heart problems. Your healthcare provider should monitor you closely to make sure you are not developing heart problems. Also, due to such problems, there is a lifetime limit to how much doxorubicin (or other anthracycline medications) you can receive. Children may be at a higher risk for heart problems due to doxorubicin, compared with adults.
     
  • Doxorubicin can decrease the bone marrow's ability to produce blood cells. This can result in anemia and other serious conditions. Because your immune system depends on certain blood cells, you may be more susceptible to infections while taking doxorubicin (see Chemotherapy and Infections). You may also be at a higher risk for bleeding (see Blood Clotting Problems and Chemotherapy). You will need regular blood tests to make sure your blood counts are not too low.
     
  • Doxorubicin (as well as other chemotherapy medications) can increase the risk of developing leukemia later in life.
     
  • If doxorubicin is not correctly injected into a vein (or if it leaks from a vein), serious damage to your skin and other tissues can occur. Often surgery is necessary to repair such damage. If you notice burning or stinging while doxorubicin is injected, be sure to tell your healthcare provider right away.
     
  • The liver helps clear doxorubicin from the body. Be sure to tell your healthcare provider if you have liver disease, as this may affect how your body handles doxorubicin.
     
  • Doxorubicin often causes nausea and vomiting. Your healthcare provider should consider giving you medications before and after your doxorubicin dose, in order to prevent and treat nausea and vomiting (see Chemotherapy and Nausea).
     
  • Doxorubicin can interact with other medications (see Drug Interactions With Doxorubicin).
     
  • Doxorubicin is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug during pregnancy (see Doxorubicin and Pregnancy).
     
  • Doxorubicin passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Doxorubicin and Breastfeeding).
     
(Precautions and Warnings With Doxorubicin Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;