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DOXORUBICIN, LIPOSOMAL (Systemic)
Some commonly used brand names are:
In the U.S.—
Liposomal doxorubicin (LIP-oh-som-al dox-oh-ROO-bi-sin) belongs to the general group of medicines known as antineoplastics. It is used to treat some kinds of cancer.
Liposomal doxorubicin seems to interfere with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by liposomal doxorubicin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.
Before you begin treatment with liposomal doxorubicin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.
Liposomal doxorubicin is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:
Before Receiving This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For liposomal doxorubicin, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to liposomal doxorubicin. Also tell your health care professional if you are allergic to any other substances, such as preservatives.
Pregnancy—This medicine may cause birth defects if either the male or the female parent is receiving it at the time of conception or if it is taken by the mother during pregnancy. In addition, many cancer medicines may cause sterility, which may be permanent. Although sterility has been reported only in male dogs treated with the active ingredient of this medicine, the possibility of an effect in human males should be kept in mind.
Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving liposomal doxorubicin. Tell your doctor right away if you think you have become pregnant while receiving liposomal doxorubicin.
Breast-feeding—Because liposomal doxorubicin may cause serious side effects in a nursing baby, breast-feeding should be stopped prior to starting liposomal doxorubicin. Talk to your doctor about how long you need to formula feed your baby after you stop taking liposomal doxorubicin.
Children—There is no specific information comparing the use of liposomal doxorubicin in children with use in any other age group. Safety and efficacy of liposomal doxorubicin in children have not been established. However, problems are more likely to occur in children younger than 2 years of age, who are usually more sensitive to the effects of the active ingredient, doxorubicin.
Older adults—This medicine has been tested in a limited number of patients 60 years of age or older and has not been shown to cause different side effects in older people than it does in younger adults. However, problems are more likely to occur in the elderly, who are usually more sensitive to the effects of the active ingredient, doxorubicin. The elderly are also more likely to have blood problems.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking liposomal doxorubicin, it is especially important that your health care professional know if you are taking any of the following:
Other medical problems—The presence of other medical problems may affect the use of liposomal doxorubicin. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
Liposomal doxorubicin is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.
While you are receiving liposomal doxorubicin, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.
This medicine often causes nausea and vomiting. However, it is very important that you continue to receive it, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.
Dosing—The dose of liposomal doxorubicin will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient"s size, and whether or not other medicines are also being taken. If you are receiving liposomal doxorubicin at home, follow your doctor"s orders or the directions on the label . If you have any questions about the proper dose of liposomal doxorubicin, ask your doctor.
Precautions While Using This Medicine
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
While you are being treated with liposomal doxorubicin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor"s approval . Liposomal doxorubicin may lower your body"s resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral poliovirus vaccine since there is a chance they could pass the poliovirus on to you. Also, avoid persons who have taken oral poliovirus vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and the mouth.
Liposomal doxorubicin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
If liposomal doxorubicin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.
Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
Side Effects of This Medicine
Along with its needed effects, a medicine 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 as soon as possible if any of the following side effects occur:
More common-in any treatment group
Black, tarry stools; blistering, peeling, redness, and/or swelling of palms of hands or bottoms of feet; blood in urine or stools; chills; cough or hoarseness; facial swelling; fever ; headache; loss of strength and energy; low blood pressure; lower back or side pain; numbness, pain, tingling, or unusual sensations in palms of hands or bottoms of feet; painful or difficult urination; pinpoint red spots on skin; shortness of breath; sore throat; sores in mouth and on lips; unusual bleeding or bruising; unusual tiredness or weakness
Less common-in any treatment group
Skin rash or itching
Rare-in any treatment group
chest pain; decreased urine output; dilated neck veins; extreme fatigue; irregular breathing; irregular heartbeat; shortness of breath; swelling of face, fingers, feet, or lower legs; tightness in chest; troubled breathing; weight gain; wheezing; Yellowing of the eyes and skin
Less common—for patients being treated for Kaposi"s sarcoma
Cough; fever; pain at place of injection ; troubled breathing; wheezing
Rare—for patients being treated for Kaposi"s sarcoma
Blurred or loss of vision; eye pain; flushed, dry skin; frequent urination; fruit-like breath odor; unusual thirst
Less common—for patients being treated for ovarian cancer
Chest pain; decreased urination; rapid weight gain; bloating or swelling of face, hands, lower legs, and/or feet; fever or chills; cough or hoarseness; lower back or side pain; painful or difficult urination
Rare—for patients being treated for ovarian cancer
Cough; difficulty swallowing; hives; pain at place of injection ; puffiness or swelling of the eyelids or around the eyes, face, lips or tongue; shortness of breath; tightness in chest; wheezing
Symptoms of overdose
Black, tarry stools; blood in urine or stools; cough or hoarseness accompanied by fever or chills; fever or chills; lower back or side pain accompanied by fever or chills; painful or difficult urination accompanied by fever or chills; pinpoint red spots on skin; sores in mouth and on lips; unusual bleeding or bruising
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common-in any treatment group
Diarrhea; nausea; vomiting
Less common-in any treatment group
Back pain; difficulty swallowing; dizziness
More common—for patients being treated for Kaposi"s sarcomaCreamy white, curd-like patches in mouth or throat; pain when eating or swallowing
Less common—for patients being treated for Kaposi"s sarcomaConstipation; headache
More common—for patients being treated for ovarian cancerAbdominal or stomach pain; loss of appetite; changes in the lining of the mouth or nose; constipation; headache; pain; rash; sore throat; tingling, burning, or prickly sensations
Less common—for patients being treated for ovarian cancerAnxiety; bad, unusual, or unpleasant (after)taste; burning, dry, or itching eyes; difficulty swallowing; change in taste; excessive tearing; itching skin; muscle aches; redness, pain, swelling of eye, eyelid, or inner lining of eyelid; trouble sleeping
Rare—for patients being treated for ovarian cancerShakiness and unsteady walk; clumsiness, unsteadiness, trembling, or other problems with muscle control or coordination; change in sense of smell; chills; cough; fever; general feeling of discomfort or illness; increased white vaginal discharge; joint pain; nausea; shivering; sore throat; sweating; thinking abnormal; vomiting
Liposomal doxorubicin causes the urine to turn reddish in color, which may stain clothes. This is not blood. It is to be expected and only lasts for 1 or 2 days after each dose is given.
Other side effects 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—for patients being treated for ovarian cancer
Less common—for patients being treated for ovarian cancer
Change in skin color
This medicine often causes a temporary and total loss of hair. After treatment with liposomal doxorubicin has ended, normal hair growth should return.
After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time, check with your doctor or nurse immediately if you notice any of the following side effects:
Fast or irregular heartbeat; shortness of breath; swelling of feet and lower legs
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, liposomal doxorubicin is used in certain patients with the following medical conditions:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
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