Adriamycin (doxorubicin) is used for the treatment of several types of cancers that affect the breasts, ovaries, bladder, lungs, thyroid, bones, muscles, nerve tissues, joints, soft tissues, and stomach. It also is used to treat some acute leukemias, Wilms’ tumor, lymphoma, bronchogenic carcinoma, and Kaposi’s sarcoma. Adriamycin also may be used to treat Ewing’s tumor, squamous cell carcinomas of the head and neck, cancer of the cervix and vagina, carcinomas of the testes, prostate, and uterus, and refractory multiple myeloma.

Recently, Adriamycin in combination with Arava (leflunomide) led to significant tumor regression in a mouse model of triple-negative breast cancer.

How Adriamycin works

Adriamycin contains doxorubicin, an anti-tumor antibiotic produced by the soil fungus Streptomyces, which inhibits DNA synthesis and damages DNA, interfering with the growth of cancer cells and killing them.

Drug administration

Adriamycin is administered as an injection into a vein. The injection takes several minutes. It may sometimes be given as a continuous infusion, where the drug is injected into a vein at a slower pace.

The duration of the treatment depends on other drugs that the patients may be taking, the type of cancer that is being treated, and how well the patient tolerates the medication.

The dosage and schedule of the drug are prescribed on an individual basis, determined by the patient’s weight and height, type of cancer, and the mode of administration.

The drug is red in color and removed through the urine, making it appear orange or reddish for one to two days after the infusion.

Warnings and precautions

Adriamycin is not advised if the patient is allergic to any drug ingredient, has certain bone marrow problems (such as low platelet counts or low red blood cells) caused by prior chemotherapy, has severe liver or heart problems, or is taking Palifermin, a drug used to treat severe sores in the mouth and throat that may be caused by cancer treatment. It also is advised not to get live vaccines while using Adriamycin.

Adriamycin should be used with caution if the patient is pregnant, planning to become pregnant, breastfeeding, taking other medicines or supplements, or receiving radiation therapy.

Drug interactions

Some medicines may interact with Adriamycin and should be used with caution. These include Cytoxan (cyclophosphamide) or Herceptin (trastuzumab), Sandimmune (cyclosporine), Taxol (paclitaxel) or verapamil; Luminal (phenobarbital), Dilantin (phenytoin) or St. John’s wort, blood-thinning medications (such as warfarin), Palifermin and medicines that harm the liver such as acetaminophen, methotrexate, and Nizoral (ketoconazole).

Side effects

Possible side effects of Adriamycin include nausea and vomiting, loss of appetite, diarrhea, difficulty swallowing, thinned or brittle hair, skin irritation or rash; darkening of nails, and swelling, pain, redness, or peeling of skin on palms and soles of the feet. Adriamycin may reduce the levels of white blood cells, red blood cells, and platelets, increasing the risk of infection and bleeding and causing fatigue.

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