DOXIL® is a prescription medication prescribed by your doctor to treat relapsed/refractory multiple myeloma. It is a type of chemotherapy drug known as an anthracycline.
Anthracyclines are a group of drugs that have been used for many years to treat a variety of cancers. They cause cancer cells to die by damaging the DNA, or the genetic makeup, of the cancer cells.
When DOXIL® is prescribed to treat relapsed/refractory multiple myeloma, it is used in combination with VELCADE® (bortezomib), another type of cancer medication.
DOXIL® is a specially coated form of doxorubicin that starts with the active agent, doxorubicin, and covers it with 2 layers of protective coating. This coating allows DOXIL® to evade detection and destruction by the immune system, which increases the time the drug is in the body. As a result, DOXIL® has more time to reach the tumor tissue, where the medication is released. However, DOXIL® may also affect normal tissue.
VELCADE® is a medication used to treat multiple myeloma. VELCADE® is also called bortezomib.
It is very important that you take an active role in your care. During the course of your DOXIL® treatment, be sure to talk to your doctor or nurse about how you feel or any concerns you may have.
When DOXIL® is prescribed to treat relapsed/refractory multiple myeloma, it is used in combination with VELCADE®, another type of cancer medication. DOXIL® and VELCADE® are intravenous (IV) medications given in a doctor’s office or clinic by a healthcare professional.
Your treatment with DOXIL® and VELCADE® will begin with VELCADE®. VELCADE® is given as a bolus injection on Days 1, 4, 8, and 11 of a 21-day treatment cycle. The VELCADE® injection will take 3-5 seconds to complete. DOXIL® will be given as an infusion on Day 4 of the treatment cycle after you receive VELCADE®. The DOXIL® infusion will take about 1 hour to complete.
You may be treated with DOXIL® and VELCADE® for up to 8 cycles depending on your response to therapy.
Be sure to tell your doctor or nurse what treatments and/or medications you have received in the past, and what prescriptions you are taking now. If you have had heart problems, or have them now, it is very important to tell your doctor or nurse. Also, let your doctor or nurse know if you have liver problems or low white blood cell counts (neutropenia), or if you are pregnant or nursing.
You should not receive DOXIL® if you have had a severe reaction to doxorubicin HCl (Adriamycin®) or to the other components of DOXIL®. Be sure to discuss any allergies you may have with your doctor or nurse. Women who are pregnant, planning on becoming pregnant, or nursing should not receive DOXIL®. If you have questions about whether or not you should receive DOXIL®, be sure to ask your doctor or nurse.
Heart-related side effects
The use of DOXIL® may lead to heart-related side effects. Symptoms of heart-related side effects may include (but are not limited to):
- Shortness of breath
- Ankle swelling
- Fatigue/persistent tiredness
- Irregular heartbeat
In some cases, these heart-related side effects may be serious and could be permanent side effects that may lead to congestive heart failure and may occur after stopping therapy. Your doctor will check your heart function regularly and closely watch the dosage of DOXIL® and any related chemotherapy agents.
Tell your doctor or nurse immediately if you experience any of the symptoms mentioned above.
Infusion-related reactions
Infusion-related reactions are side effects that can happen during the DOXIL® infusion. You will be closely observed for reactions during your infusion.
In some patients, infusion-related reactions may be managed by either slowing or stopping the infusion. In some patients, these reactions may be serious or life-threatening. If a reaction occurs, it usually happens during the first infusion.
Tell your doctor or nurse immediately during your infusion if you think you have any of these signs of infusion-related reactions during your infusions:
- Chills
- Back pain
- Headache
- Tightness in the chest or throat
- Flushed feeling
- Shortness of breath
- Facial swelling
- Dizziness or light-headedness
Changes in blood cell counts
DOXIL®, like other chemotherapy treatments, can lower blood cell counts. Changes in blood cell counts are generally moderate and reversible in patients treated with DOXIL®. In some patients, blood cell counts may be severely lowered. This can cause other unwanted effects, such as:
- Low white blood cell counts (neutropenia) that can lead to fever and infections
- Low red blood cell counts (anemia) that can make you feel tired and fatigued (a tired feeling that does not get better with rest)
- Low platelet counts (thrombocytopenia) that can reduce your body’s ability to form blood clots. This can cause any bleeding to last longer than usual
Your doctor will check your blood cell counts regularly and may adjust your treatment.
Tell your doctor or nurse if you have a fever of 100.5°F or higher at any time while you are being treated with DOXIL®.
Hand-foot syndrome
You may experience a skin reaction called hand-foot syndrome (HFS). It usually appears on the palms of the hands and the soles of the feet. Hand-foot syndrome generally appears after 2 or 3 treatment cycles, but may occur earlier. Skin-related reactions may also occur on other parts of the body, particularly where your clothes may be tight or where friction, pressure, rubbing, warmth, and/or sweating occur.
Tell your doctor or nurse if you experience any of these common signs and symptoms of HFS:
- Redness
- Numbness
- Swelling
- Rash
- Pain or tenderness
- Tingling or burning sensations
- Peeling skin
- Small blisters or small sores on the palms of your hands or soles of your feet
Stomatitis
Stomatitis is a mouth irritation that takes the form of inflammation or sores. Proper care of your mouth and avoiding certain foods and drinks can help manage stomatitis.
Tell your doctor or nurse if you experience any of these common signs of stomatitis:
- Mouth sores
- Swelling of the mouth and/or tongue
- Pain or burning in the mouth
- Inability to eat or drink
- Difficulty swallowing
Nausea and vomiting
Like other chemotherapies, DOXIL® may cause nausea and vomiting.
Nausea and vomiting are usually mild and may be managed with medications. Tell your doctor or nurse if you experience either of these symptoms. They may be able to give you medication that can help.
Additional side effects
- Tiredness, weakness, rash, shortness of breath, or mild hair loss
- Loss of appetite
- Diarrhea
- Fluid discoloration: urine and other bodily fluids may turn reddish-orange; this side effect is not harmful and will disappear as DOXIL® is eliminated from the body
- Radiation recall, a rash that appears during chemotherapy, including DOXIL®, in patients who have had prior radiation therapy
Your doctor may adjust your dose of DOXIL® if you have liver problems.
The above is not a complete list of possible side effects that may occur with DOXIL® treatment. Talk to your doctor or nurse if you experience these or any other side effects.
