Breast cancer (female)

Doxorubicin Hydrochloride (Doxorubicin 50mg/25ml solution for injection vials)

Information specific to: Doxorubicin 50mg/25ml solution for injection vials when used in Bladder cancers.

Doxorubicin hydrochloride (Dox-or-roo-biss-in hi-droh-clor-ride) is a medicine which is used in a number of conditions - an example is breast cancer.

The information in this Medicine Guide for doxorubicin hydrochloride varies according to the condition being treated and the particular preparation used.

Your medicine

Doxorubicin hydrochloride is used to treat many types of cancer. Doxorubicin hydrochloride is frequently used in combination with other medicines.

Your medical team will discuss with you the options for treating your cancer. They will take into account factors such as the type of cancer, where it is, which stage it is at and whether you have had treatment before. The results of blood tests and other investigations will also be considered.

How well you feel and how you are likely to cope with treatment is also important.

Your cancer treatment will usually consist of a treatment session with Doxorubicin hydrochloride followed by a break of a number of days before the next treatment session with Doxorubicin hydrochloride. This cycle may be repeated many times as part of your cancer treatment.

Doxorubicin hydrochloride works by damaging cancer cells in the body. Doxorubicin hydrochloride also affects healthy cells and treatment with Doxorubicin hydrochloride may damage your immune system or heart. Your medical team may arrange for you to have some tests to check how well your immune system and heart are working.

Doxorubicin hydrochloride is usually given to you by a healthcare professional. The person responsible for giving you your medicine will make sure that you get the right dose.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber or someone involved in your medical care.

Whether this medicine is suitable for you

Doxorubicin hydrochloride is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

  • are aged over 70 years
  • are allergic or sensitive to or have had a bad reaction to anthracendiones or other anthracyclines in the past
  • are allergic or sensitive to or have had a reaction to any of the ingredients in the medicine
  • are breast-feeding
  • are currently having radiotherapy
  • are immunosuppressed
  • are obese
  • are planning to have radiotherapy
  • are pregnant
  • have an infection
  • have biliary problems
  • have bladder problems
  • have blood in the urine
  • have bone marrow problems
  • have cardiomyopathy
  • have catheterisation problems
  • have gastrointestinal problems such as inflammations, ulcerations or diarrhoea
  • have had trastuzumab within the past 22 weeks
  • have had treatment with doxorubicin, anthracendiones or other anthracyclines before
  • have kidney problems
  • have liver problems
  • have mouth ulcers
  • have or have had certain heart problems
  • have recently had other treatments for cancer
  • have risk factors for certain heart problems
  • have previously had radiotherapy

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for a child or adolescent.

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to determine whether or not the medicine is suitable and whether it must be prescribed with extra care
  • to check that this medicine is not having any undesired effects

Over time it is possible that Doxorubicin hydrochloride can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Doxorubicin hydrochloride has become unsuitable, it is important that the prescriber is contacted immediately.

Alcohol

Alcohol can interact with certain medicines.

In the case of Doxorubicin hydrochloride:

  • there are no known interactions between alcohol and Doxorubicin hydrochloride

Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Doxorubicin hydrochloride:

  • there are no specific foods that you must exclude from your diet when having Doxorubicin hydrochloride

Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

In the case of Doxorubicin hydrochloride:

  • this medicine could affect your ability to drive or operate machinery

You should see how this medicine affects you before you judge whether you are safe to drive or operate machinery. If you are in any doubt about whether you should drive or operate machinery, talk to your prescriber.

Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Doxorubicin hydrochloride:

  • if you have this medicine during your pregnancy, your baby may have some problems after birth
  • you should only have this medicine during pregnancy if your doctor thinks that you need it
  • Doxorubicin hydrochloride is a medicine which has implications for pregnancy. You must not become pregnant while you are having it, and for six months after you stop having this medicine. If you could become pregnant, you must use effective contraception or abstain from penetrative sex. You must contact your prescriber if you become pregnant, or think you may have become pregnant, while having Doxorubicin hydrochloride. If you want to become pregnant after stopping Doxorubicin hydrochloride you must get advice from your doctor. Your prescriber will discuss with you how long you need to wait before you can try to get pregnant
  • it is important that you do not father a baby while having Doxorubicin hydrochloride, and for six months after you stop having this medicine. During this time you must use effective contraception or abstain from penetrative sex. You may wish to seek advice on the possibility of storing sperm before starting treatment with Doxorubicin hydrochloride

You should discuss your personal circumstances with your doctor if you are pregnant or want to become pregnant. This is so that together you can make a decision about what treatment you may need during your pregnancy.

You should discuss whether there are any other medicines which you could take during pregnancy which would treat your condition.

Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Doxorubicin hydrochloride:

  • women who are having Doxorubicin hydrochloride should not breast-feed

Before you have your baby you should discuss breast-feeding with your doctor or midwife. They will help you decide what is best for you and your baby based on the benefits and risks associated with this medicine. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed. You should not stop this medicine without taking advice from your doctor.

Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Doxorubicin hydrochloride:

  • 5-fluorouracil
  • 6-mercaptopurine
  • amphotericin B
  • ciclosporin
  • cimetidine
  • cisplatin
  • clozapine
  • cyclophosphamide
  • cytarabine
  • daunorubicin
  • digoxin
  • epirubicin
  • idarubicin
  • mercaptopurine
  • methotrexate
  • paclitaxel
  • phenytoin
  • rifampicin
  • ritonavir
  • sorafenib
  • streptozocin
  • trastuzumab

The following types of medicine may interact with Doxorubicin hydrochloride:

  • anthracenediones
  • anthracyclines
  • antineoplastic agents
  • barbiturates
  • calcium antagonists
  • cytochrome P450 enzyme inducers
  • cytochrome P450 enzyme inhibitors
  • cytostatics
  • cytotoxics
  • medicines that affect the function of the heart
  • medicines that are damaging to the heart
  • medicines that are damaging to the liver
  • p-glycoprotein inhibitors
  • uricosuric agents
  • vaccines

If you are taking Doxorubicin hydrochloride and one of the above medicines or types of medicines, make sure your prescriber knows about it.

Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins. In general, there is not much information available about interactions between medicines and complementary preparations or vitamins.

If you are planning to take or are already taking any complementary preparations and vitamins you should ask your prescriber whether there are any known interactions with Doxorubicin hydrochloride.

Your prescriber can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and vitamins may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and vitamins, you should tell your prescriber.

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