Doxorubicin Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 5, 2024.

Applies to doxorubicin: intravenous powder for solution, intravenous solution.

Important warnings This medicine can cause some serious health issues

Intravenous route (solution; powder for solution)

Myocardial damage can occur with DOXOrubicin hydrochloride with incidences from 1% to 20% for cumulative doses from 300 to 500 mg/m(2) when DOXOrubicin hydrochloride is administered every 3 weeks.

The risk of cardiomyopathy is further increased with concomitant cardiotoxic therapy.

Assess left ventricular ejection fraction (LVEF) before and regularly during and after treatment with DOXOrubicin hydrochloride.

Secondary acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) occur at a higher incidence in patients treated with anthracyclines, including DOXOrubicin hydrochloride. Extravasation of DOXOrubicin hydrochloride can result in severe local tissue injury and necrosis requiring wide excision and skin grafting.

Immediately terminate the drug, and apply ice to the affected area.

Severe myelosuppression resulting in serious infection, septic shock, requirement for transfusions, hospitalization, and death may occur.

Common side effects of doxorubicin

Some side effects of doxorubicin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• hair loss, thinning of hair
• nausea and vomiting
• sores in the mouth and on the lips

Less common

• darkening of the soles, palms, or nails
• diarrhea

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, Check with your doctor immediately if you notice the following side effects:

• fast or irregular heartbeat
• shortness of breath
• swelling of the feet and lower legs

Serious side effects of doxorubicin

Along with its needed effects, doxorubicin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking doxorubicin:

Less common

• cough or hoarseness accompanied by fever or chills
• darkening or redness of the skin (if you recently had radiation treatment)
• fast or irregular heartbeat
• fever or chills
• joint pain
• lower back or side pain accompanied by fever or chills
• pain at the injection site
• painful or difficult urination accompanied by fever or chills
• red streaks along the injected vein
• shortness of breath
• stomach pain
• swelling of the feet and lower legs

Rare

• black, tarry stools
• blood in the urine
• pinpoint red spots on the skin
• unusual bleeding or bruising

For healthcare professionals

Applies to doxorubicin: compounding powder, intravenous powder for injection, intravenous solution.

Cardiovascular

• Common (1% to 10%): Cardiomyopathy, decreased LVEF, ECG changes (e.g., sinus tachycardia, tachyarrhythmia, ventricular tachycardia, bradycardia, bundle branch block), congestive heart failure
• Very rare (less than 0.01%): Pericarditis, myocarditis
• Postmarketing reports: Cardiogenic shock, phlebosclerosis, phlebitis/thrombophlebitis, hot flashes, thromboembolism^[Ref]

Hematologic

• Very common (10% or more): Leucopenia (60% to 80%)
• Common (1% to 10%): Bone marrow suppression
• Uncommon (0.1% to 1%): Thrombocytopenia^[Ref]

Dermatologic

• Common (1% to 10%): Alopecia
• Rare (less than 0.1%): Urticaria, exanthema, local erythematous reactions along the vein which was used for the injection, hyperpigmentation of skin and nails, onycholysis
• Postmarketing reports: Oncolysis, rash, itching, photosensitivity, urticaria, acral erythema, palmar plantar erythrodysesthesia^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea and vomiting (20% to 85%), stomatitis (up to 80%), diarrhea (12%)
• Common (1% to 10%): Mucositis
• Uncommon (0.1% to 1%): Ulceration and necrosis of the colon, especially the cecum (in combination with cytarabine)^[Ref]

Local

• Frequency not reported: Extravasation, tissue necrosis^[Ref]

Hypersensitivity

• Rare (0.01% to 0.1%): Anaphylactic reactions^[Ref]

Renal

• Rare (0.01% to 0.1%): Renal insufficiency^[Ref]

Other

• Rare (0.01% to 0.1%): Shivering, fever
• Frequency not reported: Radiation recall
• Postmarketing reports: Malaise, asthenia, fever, chills^[Ref]

Oncologic

• Common (1% to 10%): Secondary malignancies^[Ref]

Ocular

• Rare (0.01% to 0.1%): Conjunctivitis
• Postmarketing reports: Keratitis, lacrimation^[Ref]

Genitourinary

• Common (1% to 10%): Local reactions (chemical cystitis) may occur with intravesical treatment
• Rare (less than 0.1%): Bladder contracture
• Frequency not reported: Amenorrhea^[Ref]

Metabolic

• Common (1% to 10%): Anorexia
• Frequency not reported: Hyperuricemia, tumor lysis syndrome
• Postmarketing reports: Weight gain^[Ref]

Hepatic

• Postmarketing reports: Increased alanine aminotransferase, increased aspartate aminotransferase^[Ref]

Respiratory

• Common (1% to 10%): Dyspnea
• Frequency not reported: Bronchospasm, cough, epistaxis, pneumonia, nasopharyngitis, upper respiratory tract infection^[Ref]

Nervous system

• Rare (0.01% to 0.1%): Dizziness
• Postmarketing reports: Peripheral sensory and motor neuropathy, seizures, coma^[Ref]

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Further information

Doxorubicin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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