Doxorubicin + Pegylated Liposomal

Indications

Doxorubicin + Pegylated Liposomal is used for: Kaposi's Sarcoma, Ovarian Cancer, Multiple Myeloma

Adult Dose

Kaposi's Sarcoma Indicated for AIDS-related Kaposi’s sarcoma in patients after failure of prior systemic chemotherapy or intolerance to such therapy 20 mg/m² IV q3Weeks Ovarian Cancer Indicated for ovarian cancer in patients whose disease has progressed or recurred after platinum-based chemotherapy 50 mg/m² IV q4Weeks x 4 courses minimum Multiple Myeloma Indicated in combination with bortezomib for multiple myeloma in patients who have not previously received bortezomib and have received at least 1 prior therapy 30 mg/m² IV on day 4 following bortezomib 1.3 mg/m² on days 1, 4, 8 & 11 q3Weeks Hepatic impairment: Reduce dose if serum bilirubin >1.2 mg/dL

Child Dose

Renal Dose

Administration

IV Preparation Dilute aseptically <90 mg doses in 250 mL & >90 mg doses in 500 mL D5W (do NOT use other IV fluids) Refrigerate at 2-8°C & administer within 24 hr Red translucent dispersion (will not be a clear solution) IV Administration Initial infusion at 1 mg/min, if no infusion reaction may increase rate to complete infusion in 1 hr Do not administer as bolus injection or undiluted suspension Do not use in-line filter Use cytotoxic precautions for handling, administration, and disposal

Contra Indications

Hypersensitivity. AIDS-KS that may be effectively treated w/ local therapy or systemic α-interferon. Pregnancy & lactation.

Precautions

History of CV disease, impaired cardiac function, patients who have received other anthracyclines. Perform periodic blood counts. Caution when administered w/ other cytotoxic agents especially myelotoxic agents.

Pregnancy-Lactation

Interactions

May exacerbate cyclophosphamide-induced hemorrhagic cystitis & enhance the hepatotoxicity of 6-mercaptopurine.

Adverse Effects

Side effects of Doxorubicin + Pegylated Liposomal : Leukopenia, anemia, thrombocytopenia; nausea, asthenia, alopecia, fever, diarrhea, infusion-associated acute reactions, stomatitis. Less frequently, palmar-plantar erythrodyesthesia.

Mechanism of Action

Anthracycline; intercalates between DNA base pairs, impairs topoisomerase II function and subsequently inhibits DNA and RNA replication Doxorubicin is a strong chelator; doxorubicin-iron complex binds to cell membranes and DNA and produces free hydroxyl radicals that cleaves them