Monograph
L01DB01 - Doxorubicin |
Propably not porphyrinogenic |
PNP |
Rationale
Substrate and weak inhibitor of CYP3A4, but no indications of CYP-inducing capacity. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Doxorubicin is an anthracycline antineoplastic antibiotic isolated from a Steptomyces peucetius strain.
Therapeutic characteristics
Doxorubicin has a wide therapeutic range and is used in the treatment of e.g. breast cancer, lung cancer, sarcoma, maligant lymphoma, and acute leuecamias. Often used in combination with other antineoplasics. Administered as an intravenous infusion. Common adverse reactions of doxorubicin that can be confused with an acute porphyric attack are vomiting and nausea. It may also colour the ruin red. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Doxorubicin is meabolised in the liver from quinone to the highly cytotoxic semiquinone by NADPH cytochrome P450 reductase. Listed as an inhibitor and substrate of CYP 3A4 by Rendic (2002). Baumhäkel et al (2001) found that doxorubicinhad only a minor inhibitory effect on human CYP 3A4. Doxorubicin does not activate PXR (Sinz, 2006; Harmsen, 2009). No interactions described pointing to interference with CYP-metabolism of other drugs. Not listed as CYP-inducer.
Published experience
Used uneventfully by 2 PV women suffering from breast cancer (Thiery-Vuillemin, 2008). Used uneventfully by 1 AIP women suffering from acute myelogenous leukemia (Wehmeier, 1987). Used uneventfully in 16-year old PV girl suffering from acute lymphoblastic leukemia. (Samuels, 1984). Used uneventfully in PV woman suffering from breast cancer (Scarlett, 1995).
IPNet drug reports
Uneventful use reported in 2 patients with acute porphyria.
Similar drugs
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | Nuclear receptor mediated induction of cytochrome P450 3A4 by anticancer drugs: a key role for the pregnane X receptor.
Harmsen S, Meijerman I, et al. Cancer Chemother Pharmacol. 2009;64(1):35-43. |
18839173 |
| 2. | Chemotherapy in porphyria.
Samuels B, Bezwoda WR, et al. S Afr Med J. 1984;65(23):924-6. |
|
| 3. | Cytotoxic chemotherapy and radiotherapy in a patient with breast cancer and variegate porphyria (VP).
Scarlett JD, Corry J, Jeal PN. Aust N Z J Med. 1995;25(6):742-3. |
|
| 4. | Evaluation of 170 xenobiotics as transactivators of human pregnane X receptor (hPXR) and correlation to known CYP3A4 drug interactions.
Sinz M, Kim S, et al. Curr Drug Metab. 2006;7(4):375-88. |
16724927 |
| 5. | Anticancer therapy in patients with porphyrias: evidence today.
Thiery-Vuillemin A, Chaigneau L, et al. Expert Opin Drug Saf. 2008;7(2):159-65. |
18324878 |
| 6. | Polychemotherapy of acute myelogenous leukemia in a patient with acute intermittent porphyria.
Wehmeier A, Fischer JT, et al. Klin Wochenschr. 1987;65(7):338-40. |
|
| * | Drug reference publications | |
| 7. | McEvoy GK, editor. Doxorubicin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (04.05.10).
|
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| 8. | Sweetman SC, editor. Martindale: The complete drug reference. Doxorubicin. Pharmaceutical Press 2009.
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| * | Summary of Product Characteristics | |
| 9. | Norwegian medicines agency. Summary of Product Characteristics (SPC). Adriamycin.
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Tradenames
This list comprises raw data collected from different countries.
In some cases, a more comprehensive list of available drug packages is included.
Consequently, very similar terms may therefore appear multiple times.
Bold names are the searchable terms, while the gray names that follow are all mapped to the bolded term.
Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors.
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Caelyx, 2 mg/ml concentraat voor oplossing voor intraveneuze infusie · Celdoxome pegylated liposomal 2 mg/ml concentraat voor dispersie voor infusie · Doxorubicine Accord 2 mg/ml concentraat voor oplossing voor infusie · Doxorubicine HCl Eugia 2 mg/ml, concentraat voor oplossing voor infusie · Doxorubicine HCl Hikma 2 mg/ml, concentraat voor oplossing voor infusie · Doxorubicine hydrochloride 2 mg/ml PCH, concentraat voor oplossing voor infusie · Myocet liposomaal 50 mg poeder, dispersie en oplosmiddel voor concentraat voor dispersie voor infusie · Zolsketil pegylated liposomal 2 mg/ml concentraat voor oplossing voor infusie 
Adriblastina 10 Ready To Use 10 mg sol. inj. i.v. flac. · Adriblastina 20 Ready To Use 20 mg sol. inj. i.v. flac. · Adriblastina 200 Ready To Use 200 mg sol. inj. i.v. flac. · Adriblastina 50 Ready To Use 50 mg sol. inj. i.v. flac. · Celdoxome · Celdoxome Pegylated Liposomal 2 mg/ml disp. perf. (? diluer) i.v. flac. · Doxorubicin · Doxorubicin Accord Healthcare 2 mg/ml sol. perf. (? diluer) i.v. flac. · Doxorubicine · Doxorubicine Teva 2 mg/ml sol. perf. (? diluer) i.v. flac. · Myocet · Myocet Liposomal 50 mg disp. perf. (pdr. + disp. + solv., ? diluer) i.v. flac. · Zolsketil · Zolsketil Pegylated Liposomal 2 mg/ml disp. perf. (? diluer) i.v. flac. 
Caelyx Pegylated Liposomal 2 mg/ml Concentrado Para Solucion Para Perfusion · Doxorubicina · Doxorubicina Accord 2 mg/ml Concentrado Para Solucion Para Perfusion efg · DOXORUBICINA AUROVITAS 2 mg/ml CONCENTRADO PARA SOLUCION PARA PERFUSION EFG · Doxorubicina Tedec 2 mg/ml Concentrado Para Soluci?n Para Perfusi?n · Farmiblastina · Farmiblastina 2 mg/ml Concentrado Para Soluci?n Para Perfusi?n · FARMIBLASTINA 50 mg POLVO PARA SOLUCION INYECTABLE · Myocet Liposomal 50 mg Polvo, Dispersion y Disolvente Para Concentrado Para Dispersion Para Perfusion · Zolsketil Pegylated Liposomal 2 mg/ml Concentrado Para Dispersion Para Perfusion 
CAELYX PEGYLATED LIPOSOMAL 2 mg/ml · DOXORUBICINA ACCORD 2 mg/ml · MYOCET LIPOSOMAL 50 mg · ZOLSKETIL PEGYLATED LIPOSOMAL 2 mg/ml 
Caelyx · Doxorubicin · Doxorubicin Rapid Dissolution · Doxorubin · Myocet 
Adriamycin · Caelyx pegylated liposomal · Celdoxome pegylated liposomal · Doxorubicin Accord · Doxorubicin Ebewe · Doxorubicin Teva · Myocet · ZOLSKETIL pegylated liposomal 
Adriamycin · Caelyx pegylated liposomal · Doxorubicin Accord · Doxorubicin Ebewe · Zolsketil pegylated liposomal 
Adriblastina PFS · Caelyx pegylated liposomal · Celdoxome pegylated liposomal · Doxorubicin-Ebewe · Doxorubicinum Accord · Myocet liposomal · ZOLSKETIL pegylated liposomal 
Adriblastina · Caelyx pegylated liposomal · Doxorubicine Teva · Myocet liposomal · ZOLSKETIL pegylated liposomal 
Caelyx pegylated liposomal · Celdoxome pegylated liposomal · Doxorubicin Actavis · Doxorubicin medac · Myocet liposomal · Zolsketil pegylated liposomal 
Caelyx Pegylated Liposomal · Celdoxome pegylated liposomal · Doxorubicin Accord · Doxorubicin medac · Myocet Liposomal · ZOLSKETIL pegylated liposomal 
Caelyx pegylated liposomal · Celdoxome pegylated liposomal · Doxorubicin Accord · Myocet liposomal · Zolsketil pegylated liposomal 
Adriamycin® CS · Adriblastina® RD · Doxorubicinum Accord
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