What is this medication?

DOXORUBICIN (dox oh ROO bi sin) is a chemotherapy drug. It is used to treat many kinds of cancer like leukemia, lymphoma, neuroblastoma, sarcoma, and Wilms' tumor. It is also used to treat bladder cancer, breast cancer, lung cancer, ovarian cancer, stomach cancer, and thyroid cancer.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Adriamycin, Adriamycin PFS, Adriamycin RDF, Rubex

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• heart disease
• history of low blood counts caused by a medicine
• liver disease
• recent or ongoing radiation therapy
• an unusual or allergic reaction to doxorubicin, other chemotherapy agents, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This drug is given as an infusion into a vein. It is administered in a hospital or clinic by a specially trained health care professional. If you have pain, swelling, burning or any unusual feeling around the site of your injection, tell your health care professional right away.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment.

What may interact with this medication?

This medicine may interact with the following medications:

• 6-mercaptopurine
• paclitaxel
• phenytoin
• St. John's Wort
• trastuzumab
• verapamil

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

There is a maximum amount of this medicine you should receive throughout your life. The amount depends on the medical condition being treated and your overall health. Your doctor will watch how much of this medicine you receive in your lifetime. Tell your doctor if you have taken this medicine before.

You may need blood work done while you are taking this medicine.

Your urine may turn red for a few days after your dose. This is not blood. If your urine is dark or brown, call your doctor.

In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.

Do not become pregnant while taking this medicine or for 6 months after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 6 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

This medicine has caused ovarian failure in some women and reduced sperm counts in some men This medicine may interfere with the ability to have a child. Talk with your doctor or health care professional if you are concerned about your fertility.

This medicine may cause a decrease in Co-Enzyme Q-10. You should make sure that you get enough Co-Enzyme Q-10 while you are taking this medicine. Discuss the foods you eat and the vitamins you take with your health care professional.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• chest pain
• fast or irregular heartbeat
• low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
• pain, redness, or irritation at site where injected
• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine
• swelling of the ankles, feet, hands
• tiredness
• weakness

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• hair loss
• mouth sores
• nail discoloration or damage
• nausea
• red colored urine
• vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This drug is given in a hospital or clinic and will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.