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Doxorubicin hydrochloride is chemotherapy that is given as a treatment for many different types of cancer. It used to be called Adriamycin and some doctors and nurses still use this name. This section describes doxorubicin, how it is given and some of its possible side effects. It should ideally be read with CancerBACUP's general information on chemotherapy, which gives more information and advice.
You will see your doctor regularly while you have this treatment so that they can monitor the effects of the chemotherapy. This section should help you to discuss any queries about your treatment and its side effects with your doctor or chemotherapy nurse, as they are in the best position to help and advise you.
Doxorubicin hydrochloride is a red fluid.
Doxorubicin hydrochloride is given:
Each person's reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. The side effects described in this section will not affect everyone who is given doxorubicin, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common and the less common side effects, so that you can be aware of them if they occur. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you do notice any effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor or chemotherapy nurse.
Hair loss usually starts 3-4 weeks after the first dose of doxorubicin, although it may happen earlier. Hair may be lost completely. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and the hair will regrow once the treatment ends.
Nausea (feeling sick) and vomiting There are now very effective anti-sickness drugs to prevent or greatly reduce nausea and vomiting. If it occurs it may begin a few hours after the treatment is given and last for up to a day. If the sickness is not controlled, or continues, tell your doctor, who can prescribe other anti-sickness drugs that may be more effective.
Temporary reduction in the production of blood cells by the bone marrow This can result in anaemia leading to tiredness; an increased risk of bruising or bleeding and an increased risk of infection.
This effect can begin about seven days after the treatment has been given and the number of blood cells usually reaches its lowest point at 10-14 days after the chemotherapy. The number of blood cells will then increase steadily and will usually return to normal within 21-28 days.
The extent to which your blood cells are reduced depends on the dose of chemotherapy you have and which other chemotherapy drugs, if any, are given in combination. Your doctor can advise you how likely it is that the number of blood cells will be lowered by the chemotherapy. Your blood will be checked regularly to see how well your bone marrow is working.
If your temperature goes above 38°C (100.5°F); you develop any unexplained bruising or bleeding; or you suddenly feel unwell, even with a normal temperature, contact your doctor or the hospital straight away.
Sore mouth and taste change Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your doctor if you do have any of these problems as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
You may notice that your food tastes different. Normal taste will come back after the treatment finishes.
Discoloured urine Your urine may become a pink-red colour. This may last up to 24 hours after you have had the doxorubicin, and is due to the colour of the drug. It is quite normal.
Skin changes Your skin may darken, due to excess production of pigment. This usually returns to normal a few months after the treatment has finished.
Sensitivity to the sun While you are having doxorubicin, and for several months afterwards, you will be more sensitive to the sun, and your skin may burn more easily than normal. You can still go out in the sun, but always wear a high protection factor suncream and protective clothing.
Tiredness and a general feeling of weakness It is important to allow yourself plenty of time to rest.
Changes in the way your heart works Higher doses of doxorubicin hydrochloride may cause changes in the muscle of the heart. This can affect how the heart works. The effect on the heart depends on the dose given. It is very unusual for the heart to be affected if you receive standard doses. Tests to see how well your heart is working may sometimes be carried out before the drug is given.
Diarrhoea can usually be easily controlled with medicine but tell your doctor if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea.
Skin changes The skin may become red and sore in areas which have previously been treated with radiotherapy. Let your doctor know if this happens. The skin over the vein used for the injection may become discoloured.
Changes in nails Your nails may become darker. White lines may appear on them. These changes usually grow out over a few months once treatment has finished.
If doxorubicin hydrochloride leaks into the tissue around the vein it can cause damage. If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site it is very important that you tell your nurse or doctor.
If the area around the injection site becomes red or swollen at any time you should either tell the doctor or nurse on the ward, or if you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.
Some people have hot flushes when the drug is being given.
Some medicines can be harmful to take when you are having chemotherapy. Always tell your doctor about any other medicine you are taking.
Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.
Contraception It is not advisable to become pregnant or father a child while taking doxorubicin hydrochloride as it may harm the developing foetus. It is important to use effective contraception whilst taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.
This section has been compiled using information from a number of reliable sources including;
For futher references, please see general bibliography.