Epidoxorubicin HCl

Indications

Epidoxorubicin HCl is used for: AIDS-related Kaposi's sarcoma, ovarian carcinoma, breast carcinoma, malignant neoplasms in the bladder

Adult Dose

Intravenous AIDS-related Kaposi's sarcoma Adult: As pegylated liposome: 20 mg/m2 BSA infused over 30 min once every 2-3 wk. Hepatic impairment: Moderate impairment (serum-bilirubin: 12-30 mcg/mL): Half the normal dose; severe impairment (serum-bilirubin >30 mcg/mL): Quarter of the usual dose. Intravenous Ovarian carcinoma Adult: As pegylated liposome: 50 mg/m2 BSA infused over 1 hr once every 4 wk. Hepatic impairment: Moderate impairment (serum-bilirubin: 12-30 mcg/mL): Half the normal dose; severe impairment (serum-bilirubin >30 mcg/mL): Quarter of the usual dose. Intravenous Metastatic breast cancer Adult: 60-75 mg/m2 BSA once every 3 wk in combination with cyclophosphamide given as an infusion over 1 hr diluted in 0.9% sodium chloride or 5% glucose. Hepatic impairment: Moderate impairment (serum-bilirubin: 12-30 mcg/mL): Half the normal dose; severe impairment (serum-bilirubin >30 mcg/mL): Quarter of the usual dose. Irrigation Local malignant neoplasms in the bladder Adult: 50 ml of a 1 mg/ml solution instilled into the bladder for 1 hr once a mth. Hepatic impairment: Moderate impairment (serum-bilirubin: 12-30 mcg/mL): Half the normal dose; severe impairment (serum-bilirubin >30 mcg/mL): Quarter of the usual dose.

Child Dose

Renal Dose

Administration

Contra Indications

Cardiac disease, neonates, pregnancy and lactation, prior irradiation to mediastinum. IM/SC admin. Severe myelosuppression due to previous treatment with antitumour agents or radiotherapy.

Precautions

Elderly, children, hepatic impairment. Monitor blood counts and ECG.

Pregnancy-Lactation

Interactions

Doxorubicin interacts with a number of other drugs e.g. antibiotics (aminoglycosides), steroids, aminophylline and propranolol. Potentially Fatal: Cholestasis induced by mercaptopurine may be potentiated by concurrent administration of the drug. Toxicity may be increased if streptozocin is given concurrently.

Adverse Effects

Side effects of Epidoxorubicin HCl : Leucopenia, thrombocytopenia, nausea, vomiting, diarrhoea. Rarely facial flushing, rash, alopecia. Blurred vision, headache, seizures, paraesthesia, confusion, malaise, lethargy, skin pigmentation. Potentially Fatal: Bone marrow suppression, cardiotoxicity.

Mechanism of Action

Doxorubicin is a cytotoxic anthracycline antibiotic. The cytotoxic action results from its binding to DNA and inhibition of nucleic acid synthesis. Doxorubicin has been shown to produce regression in a variety of disseminated malignancies.