Anthracyclines

Doxorubicin (Adriamycin, Rubex) is an anthracycline used to treat lung cancer.

• Who should not use these medications:
  
  
  • People with extremely low white blood cell or platelet counts
  
  
  
  • Individuals who have received the maximum cumulative dose of doxorubicin or other anthracyclines, such as daunorubicin (Cerubidine) or idarubicin (Idamycin)
  
  
  
  • Evaluation is needed to determine if people with preexisting heart failure are able to take anthracyclines.


• Use: Anthracyclines are administered by an IV injection on the first day of each chemotherapy cycle.



• Drug or food interactions: The risk of anthracyclines further reducing blood cell counts and causing anemia or bleeding may increase when they are used with other chemotherapy drugs. Anthracyclines may delay the effects of blood thinners, such as warfarin (Coumadin), or platelet (cells in blood that help clotting) inhibitors, such as aspirin. Anthracyclines may decrease the effectiveness of antiseizure medications, such as phenytoin (Dilantin) or carbamazepine (Tegretol). Phenobarbital may decrease effectiveness of anthracyclines.



• Side effects: Anthracyclines may cause a person to bleed or to develop infections more easily. A doctor will check blood and urine for abnormalities that may be caused by these drugs. Anthracyclines may cause heart problems, such as congestive heart failure or abnormal heart rhythm.
  
  
  • A doctor should be contacted immediately if any of the following side effects occur:
    
    
    • Unusual bleeding or bruising
    
    
    
    • Bloody urine, bowel movement, or vomit
    
    
    
    • Difficulty swallowing
    
    
    
    • Chest pain
    
    
    
    • Unexplained fever, chills, or sore throat
    
    
    
    • Sores or ulcers around or in the mouth
    
    
    
    • Redness, pain, or swelling where the IV is given
    
    
    
    • Wheezing or trouble breathing
    
    
    
    • Severe nausea, vomiting, or diarrhea
    
    
    
    • Yellowing of skin or eyes
    
    
    
  • Other side effects include the following:
    
    
    • Hair loss
    
    
    
    • Poor appetite
    
    
    
  • People aged 50 years or older need to have their cardiac ejection fraction checked because of the risk for congestive heart failure associated with anthracyclines. Cardiac ejection fraction is a test that measures how well the heart is able to pump blood.