Doxorubicin (Adriamycin)

General information

Class/mechanism: Anthracycline; binds and intercalates into DNA, inhibiting nucleotide replication and DNA/RNA polymerase activity. Intercalation of DNA triggers DNA cleavage via topoisomerase II. Toxic effects on organs may be related to cell membrane lipid binding activities; enzymatic electron reduction of doxorubicin creates reactive species, e.g. hydroxyl free radicals OH-, which has been implicated in cardiotoxicity by means of Cu (II) and Fe (III) reduction.^[1]^[2]
Route: IV
Extravasation: vesicant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.^[1]

Diseases for which it is established (work in progress)

Diseases for which it is used

Diseases for which it was used

Patient drug information

History of changes in FDA indication

1974-08-07: Initial FDA approval
2003-05-08: Earliest date with label information at Drugs @ FDA: "Doxorubicin has been used successfully to produce regression in disseminated neoplastic conditions such as acute lymphoblastic leukemia, acute myeloblastic leukemia, Wilms’ tumor, neuroblastoma, soft tissue and bone sarcomas, breast carcinoma, ovarian carcinoma, transitional cell bladder carcinoma, thyroid carcinoma, gastric carcinoma, Hodgkin’s disease, malignant lymphoma and bronchogenic carcinoma in which the small cell histologic type is the most responsive compared to other cell types. (No supporting studies are cited)
Uncertain date: Doxorubicin is also indicated for use as a component of adjuvant therapy in women with evidence of axillary lymph node involvement following resection of primary breast cancer. (Based on EBCTCG 1998 meta-analysis)

History of changes in EMA indication

1996-06-21: EURD

History of changes in PMDA indication

2014-12-18: Revised indication and a new dosage for the relief of symptoms of malignant lymphoma.

Also known as

Code name: FI-106
Generic names: ADM, doxorubicin hydrochloride, hydroxydaunorubicin
Brand names:

Synonyms
Adriablastina	Adriacept	Adriacin	Adriamycin	Adriamycine	Adriblastin	Adriblastina	Adriblastine
Adricept	Adricin	Adrim	Adrimedac	Adrosal	Antraciclin	Biorrub	Biorubina
Cadria	Carcinocin	Cloridrato DE	Doxorrubicina Colhidrol	Deldoxin	Dicladox	Dobicin	Dobixin
Doxo	Doxobin	Doxo Cell	Doxocris	Doxokebir	Doxolem	Doxonolver	Doxor
Doxorrubicina	Doxoruben	Doxorubicina	Doxorubicine	Doxorubicinum	Doxorubin	Doxotec	Doxtie
Duxocin	Evacet	Farmiblastina	Fauldoxo	Flavicina	Ifadox	Kemodoxa	Lyphidox
Nagun	Neoxane	Nuaze	Oncodria	Onkodox	Onkostatil	Pallagicin	Ranxas
Rastocin	Ribodoxo	Roxorin	Rubex	Varidoxo	Zodox

References

Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1998 Sep 19;352(9132):930-42. link to original article PubMed

[insert-1] 1.0 ^1.1 ^1.2 Doxorubicin (Adriamycin) package insert

[2] Doxorubicin (Adriamycin) package insert (locally hosted backup)

[3] Doxorubicin (Adriamycin) patient drug information (Chemocare)

[4] Doxorubicin (Adriamycin) patient drug information (UpToDate)

[1]

[2]

[3]

[4]