What is Doxil?

DOXOrubicin hydrochloride (HCl) can cause myocardial damage which can lead to congestive heart failure as the total cumulative dose (including anthracyclines or anthracenediones) approaches 550 mg/m (2). Cardiac toxicity may also occur at lower cumulative doses with mediastinal irradiation or concurrent cardiotoxic agents. Serious and sometimes life-threatening or fatal infusion reactions have been reported. Symptoms may include flushing, shortness of breath, facial swelling, headache, chills, back pain, tightness in the chest or throat, or hypotension .

Doxorubicin liposome injection is used to treat ovarian cancer and Kaposi sarcoma (AIDS patients). It is also used together with bortezomib to treat multiple myeloma. Doxorubicin liposome is an antineoplastic agent (cancer medicine).

Doxorubicin liposome interferes with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal body cells may also be affected by doxorubicin liposome, other unwanted side effects will also occur. Some of these may be serious and must be reported to your doctor.

This medicine is to be given only by or under the direct supervision of your doctor.

A doctor or other trained health professional will give you this medicine in a hospital or cancer treatment center. This medicine is given through a needle placed in your vein.

Do not substitute Doxil® for doxorubicin HCl injection.

This medicine often causes nausea and vomiting. Your doctor may give you medicine to prevent this. Talk to your doctor if you continue to have nausea and vomiting after you receive the medicine.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Appropriate studies have not been performed on the relationship of age to the effects of doxorubicin liposome injection in the pediatric population. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of doxorubicin liposome injection in the elderly.

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Atazanavir
• Boceprevir
• Cobicistat
• Lopinavir
• Nelfinavir
• Saquinavir
• Telaprevir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abiraterone
• Amiodarone
• Amitriptyline
• Amobarbital
• Amprenavir
• Aprepitant
• Aprobarbital
• Azathioprine
• Azithromycin
• Bosentan
• Bupropion
• Butabarbital
• Butalbital
• Captopril
• Carbamazepine
• Carvedilol
• Ceritinib
• Chlorpromazine
• Cinacalcet
• Ciprofloxacin
• Cisplatin
• Clarithromycin
• Clobazam
• Clozapine
• Conivaptan
• Crizotinib
• Cyclophosphamide
• Cyclosporine
• Darunavir
• Delavirdine
• Desipramine
• Dexamethasone
• Dexrazoxane
• Diltiazem
• Dronedarone
• Duloxetine
• Efavirenz
• Enzalutamide
• Erythromycin
• Etravirine
• Felodipine
• Fluconazole
• Fluoxetine
• Fluphenazine
• Fluvoxamine
• Fosamprenavir
• Fosaprepitant
• Fosphenytoin
• Imatinib
• Indinavir
• Itraconazole
• Ketoconazole
• Mephobarbital
• Mercaptopurine
• Methohexital
• Miconazole
• Mifepristone
• Modafinil
• Morphine
• Morphine Sulfate Liposome
• Nafcillin
• Nefazodone
• Nevirapine
• Oxcarbazepine
• Paclitaxel
• Paroxetine
• Pentobarbital
• Phenobarbital
• Phenytoin
• Piperaquine
• Posaconazole
• Quercetin
• Quinidine
• Ranolazine
• Regorafenib
• Rifabutin
• Rifampin
• Rifapentine
• Ritonavir
• Secobarbital
• Simeprevir
• Stavudine
• St John's Wort
• Telithromycin
• Terbinafine
• Thiopental
• Thioridazine
• Ticagrelor
• Tipranavir
• Tocophersolan
• Trastuzumab
• Valspodar
• Verapamil
• Vinflunine
• Voriconazole
• Warfarin
• Zidovudine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Eltrombopag
• Sorafenib

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Congestive heart failure or
• Heart or blood vessel disease, history of—Use with caution. May make these conditions worse.

• Infection—May decrease your body's ability to fight infection.

• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

It is very important that your doctor check you at regular visits while you are receiving this medicine to make sure it is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control while you are receiving this medicine and for 6 months after treatment to keep from getting pregnant. If you think you or your partner have become pregnant, tell your doctor right away.

Talk with your doctor before using this medicine if you plan to have children. Some men and women who use this medicine have become infertile (unable to have children).

Check with your doctor right away if you have chest pain or discomfort, a fast or irregular heartbeat, swelling of the feet and lower legs, or troubled breathing. These could be symptoms of a serious heart problem.

This medicine may cause an infusion reaction, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have chest tightness, a cough, dizziness, a fast heartbeat, trouble breathing, trouble swallowing, swelling in your face or hands, a fever or chills, or lightheadedness or faintness while you are receiving this medicine.

This medicine may cause hand-foot syndrome. Check with your doctor right away if you have tingling or burning, redness, swelling, blistering, or small sores on the palms of your hands or soles of your feet.

Doxorubicin liposome can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury can occur.

If you continue to receive this medicine for a full year, tell your doctor right away if you have any discomfort, pain, sores or ulcers in your mouth. These could be symptoms of oral cancer.

Tell your doctor right away if you notice redness, pain, or swelling at the injection site after you receive this medicine. If doxorubicin liposome accidentally leaks out of the vein where it is injected, it may damage the skin and cause scars.

This medicine may cause your urine color to be red or orange for 1 or 2 days after you receive the injection. This is normal.