Doxil Warnings and Precautions
Because Doxil can decrease the bone marrow's ability to produce blood cells, anemia and other serious conditions can occur in people using it. Other warnings and precautions with Doxil apply to people with heart problems, women who are pregnant, and people with liver disease. This chemotherapy medicine is not recommended for people who are allergic to any of its ingredients.
What Should I Tell My Healthcare Provider Before Receiving Doxil?Prior to receiving Doxil® (liposomal doxorubicin), tell your healthcare provider if you have:
- Congestive heart failure (CHF), an irregular heart rhythm (arrhythmia), or other heart problems
- A history of low levels of white blood cells in the blood (known medically as neutropenia)
- Any infection
- Liver disease, including liver failure or cirrhosis
- Had radiation
- Any allergies, including to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and nonprescription medications, vitamins, and herbal supplements.
Specific Precautions and Warnings With DoxilSome warnings and precautions to be aware of prior to using this drug include the following:
- Doxil can increase your risk of congestive heart failure (CHF), arrhythmias, or other heart problems. Your healthcare provider should monitor you closely to make sure you are not developing heart problems. Also, due to such problems, there is a lifetime limit to how much Doxil (or other anthracycline medications) you can receive.
- Infusion reactions (reactions that occur while the drug is being administered) occur in up to 7.1 percent of people given Doxil. Signs and symptoms of an infusion reaction include:
For most people, the symptoms of an infusion reaction gradually improve within a few hours after the infusion is finished. In many cases, the reactions are not serious, although serious allergic reactions are possible.
- Doxil can decrease the bone marrow's ability to produce blood cells. This can result in anemia and other serious conditions.
Because your immune system depends on certain blood cells, you may be more susceptible to infections while using Doxil (see Chemotherapy and Infections). You may also be at a higher risk for bleeding (see Blood Clotting Problems and Chemotherapy). You will need regular blood tests to make sure your blood counts are not too low.
- Doxil often causes hand-foot syndrome (HFS), a side effect of some chemotherapy medications. This causes redness, pain, swelling, and sometimes peeling of the palms of the hands and the soles of the feet. It is more likely to occur after two or three cycles of Doxil, although sometimes it may occur sooner.
For most people, HFS is mild and goes away within a few weeks (and therefore does not interfere with the chemotherapy schedule). Occasionally, though, HFS may be severe enough to require a Doxil dosage reduction or a delay in the chemotherapy schedule.
- This medication may cause radiation recall reactions (a recurrence of radiation reactions that takes place weeks, months, or even years after the radiation has occurred) in people who have had previous radiation treatments.
- If Doxil is not correctly injected into a vein, or if it leaks from a vein, serious damage to your skin and other tissues can occur. Often, surgery is necessary to repair such damage. If you notice burning or stinging while receiving an infusion, be sure to tell your healthcare provider right away.
- The liver helps clear Doxil from the body. Be sure to tell your healthcare provider if you have liver disease, as this may affect how your body handles this medicine.
- Doxil often causes nausea and vomiting. Your healthcare provider should consider giving you medications before and after your Doxil dose in order to prevent and treat nausea and vomiting (see Chemotherapy and Nausea).
- Doxil can interact with other medications (see Doxil Drug Interactions).
- This product is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using this medication when pregnant (see Doxil and Pregnancy).
- It is unknown if this medication passes through breast milk (see Doxil and Breastfeeding).