#高警訊藥品

乳癌、卵巢癌、卡波西氏肉瘤、多發性骨髓瘤 Metastatic breast cancer; Metastatic ovarian cancer; AIDS related Kaposi's sarcoma; Multiple myeloma

Antineoplastic Agent, Anthracycline; Topoisomerase II Inhibitor
Doxorubicin inhibits DNA and RNA synthesis by intercalation between DNA base pairs by inhibition of topoisomerase II and by steric obstruction. Doxorubicin is also a powerful iron chelator; the iron-doxorubicin complex can bind DNA and cell membranes and produce free radicals that immediately cleave the DNA and cell membranes.

1. Hypersensitivity related to administration of any liposomal doxorubicin formulation or free doxorubicin.
2. Impaired liver function

D; First trimester exposure should be avoided

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer does not recommend breastfeeding during doxorubicin therapy and for 10 days after the last doxorubicin dose.

1. Acute cardiotoxicity: AV block, bradycardia, ECG abnormality, extrasystoles, nonspecific ST or T wave changes on ECG, sinus tachycardia, supraventricular tachycardia, ventricular tachycardia
2. Delayed cardiotoxicity: Cardiac failure, decreased LVEF, myocarditis, pericarditis
3. Central nervous system: Malaise
4. Dermatologic: Alopecia, discoloration of sweat, pruritus, skin photosensitivity, skin rash, urticaria
5. Endocrine & metabolic: Amenorrhea, dehydration, hyperuricemia
6. GI: Abdominal pain, diarrhea, discoloration of saliva, gastrointestinal ulcer, mucositis, nausea, vomiting
7. GU: Urine discoloration, infertility
8. Hematologic: Leukopenia, neutropenia, anemia, thrombocytopenia
9. Local: Post-injection flare
10. Neuromuscular: Weakness
11. Ophthalmic: Discoloration of tears
12. Miscellaneous: Necrosis (colon), radiation recall phenomenon

Metastatic breast cancer, ovarian cancer:
1. Dose: IVF 50 mg/m2 once every four weeks
2. Rate: Initial infusion rate ≤1mg/min, may adjust to infuse within 60 minutes if tolerated
AIDS related Kaposi's sarcoma:
IVD 20 mg/m2 once (within 30 minutes) every 2-3 weeks; the given interval should not be less than 10 days
Multiple myeloma:
30 mg/m2 (within 1 hour) given after Bortezomib on day 4 of the 3-week cycle

1. CrCl >10 mL/minute: No dosage adjustment necessary
2. CrCl <10 mL/minute: No need for dosage adjustment is expected
3. Hemodialysis: Consider administering 75% of the original dose

1. Serum bilirubin 1.2 to 3 mg/dL: Administer 50% of dose.
2. Serum bilirubin 3.1 to 5 mg/dL: Administer 25% of dose.
3. Severe hepatic impairment (Child-Pugh class C or bilirubin >5 mg/dL): Use is contraindicated.

1. Reconstitution: The reconstituted solution is stable for 7 days at room temperature and 15 days under refrigeration.
2. Dilution: Dilute with 5% dextrose (250 mL) for clinical use, solutions should be refrigerated at 2 to 8 ℃