Doxorubicin

Doxorubicin (Adriamycin) is a type of chemotherapy used to treat all stages of breast cancer. This medicine is part of a class of chemotherapy drugs called anthracyclines.

Doxorubicin may also be called Adriamycin PFS, Adriamycin RDF, doxorubicin hydrochloride, hydroxydaunorubicin, or Rubex.

It is made from the Streptomyces peucetius bacteria.

How doxorubicin works

Doxorubicin damages the DNA replication cycle inside cancer cells. This damage stops the cells from dividing, which causes them to die.

Who gets doxorubicin

Doxorubicin may be used in chemotherapy treatment regimens for most types of invasive breast cancer, such as hormone receptor-positive breast cancer and triple-negative breast cancer. It can also be used with targeted therapy, such as trastuzumab (Herceptin), to treat HER2-positive breast cancers.

Doxorubicin can be used after surgery (adjuvant treatment) or before surgery (neoadjuvant treatment).

Doxorubicin is also sometimes used to treat metastatic breast cancer.

How doxorubicin is given

Although it can be given alone, doxorubicin is usually given with other chemotherapy medicines. Common combinations used in breast cancer are:

• AC (Adriamycin and Cyclophosphamide
• AC-T (Adriamycin, Cyclophosphamide and Taxol)
• CAF (Cyclophosphamide, Adriamycin and Fluorouracil)
• TAC (Taxotere, Adriamycin and Cyclophosphamide)
• AT (Adriamycin and Taxotere)

Doxorubicin is given by vein. It is usually given in several cycles with a day (or days) of treatment followed by a period of “off” days. The exact schedule depends on the group of medicines you receive.

In some cases, your doctor may recommend a dose-dense schedule, which means medicines are given with less time between treatments than in a standard chemotherapy treatment plan. For example, one common treatment regimen is dose-dense doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) every 2 weeks for four cycles followed by paclitaxel (Taxol) every 2 weeks for four cycles.

An entire course of chemotherapy usually takes from 3 to 6 months.

Side effects and things to remember

Common side effects include:

• Low red and white blood cell counts
• Low platelet count and increased risk of bleeding
• Menopausal symptoms
• Pain near the site where the medicine was given
• Hair loss
• Mouth sores
• Nausea and vomiting

Less common side effects include:

• Heart problems (your doctor may monitor your heart throughout treatment)
• Nail and skin changes

Before starting doxorubicin, tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the-counter medicines. You should not take doxorubicin during the first trimester of pregnancy.

Share any existing or previous health problems with your doctor, especially if you have a history of heart disease. Your doctor will test you for heart problems before you start treatment with doxorubicin and will monitor your heart closely during treatment. Your doctor may suggest you drink extra fluids to prevent kidney problems.

Seek immediate medical care if you develop fever, shortness of breath or difficulty breathing, swelling or hives or blistering at the IV site.

Talk to your doctor, pharmacist, or nurse about all your side effects so that they can help you manage them. You can also go to our section on side effects for more information.