Adverse Effects
Acute adverse effects of doxorubicin can include nausea, vomiting, heart arrhythmias and Typhlitis, an acute life-threatening infection of the bowel. It can also cause neutropenia (a decrease in white blood cells), as well as complete alopecia (hair loss). A more mild side effect is discoloration of the urine, which can turn bright red for up to 48 hours after dosing. When the cumulative dose of doxorubicin reaches 550 mg/m², the risks of developing cardiac side effects, including CHF, dilated cardiomyopathy, and death, dramatically increase. Doxorubicin cardiotoxicity is characterized by a dose-dependent decline in mitochondrial oxidative phosphorylation. Reactive oxygen species, generated by the interaction of doxorubicin with iron, can then damage the myocytes (heart cells), causing myofibrillar loss and cytoplasmic vacuolization. Additionally, some patients may develop PPE, characterized by skin eruptions on the palms of the hand or soles of the feet, swelling, pain and erythema.
Due to these side effects and its red color, doxorubicin has earned the nickname "red devil" or "red death."
Chemotherapy can cause reactivation of hepatitis B, and doxorubicin-containing regimens are no exception.
Doxorubin and several chemotherapeutic drugs (including cyclophosphamide) cause dyspigmentation. Other groups of drugs that cause this problem include antimalarials, amiodarone, heavy metals (but not iron), tetracyclines, and antipsychotics.
Read more about this topic: Doxorubicin
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