Understanding Side Effects
DOXIL®, like all chemotherapies, affects cancer cells and normal cells. This is why treatment may lead to side effects. Some side effects of DOXIL® can be serious.
It is important to be aware of possible side effects so you can learn to recognize them and learn tips that may help manage some of the side effects that you may experience during treatment.
Serious, and possibly permanent, heart-related side effects that may lead to congestive heart failure can occur in patients treated with DOXIL®. Inform your doctor of any history of heart disease, radiation to your chest, or prior chemotherapy. Your doctor may monitor your heart function.
Signs of heart-related side effects from the use of DOXIL® 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 occur after stopping therapy.
Tell your doctor or nurse immediately if you experience any of the symptoms mentioned above.
Infusion-related reactions are side effects that can happen during the DOXIL® infusion. These side effects have been seen in up to 10% of patients during their DOXIL® infusion, so 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 though they are rarely fatal. If a reaction occurs, it usually happens during the first infusion. For most patients, these reactions may resolve within several hours to a day once the infusion is stopped or, for some patients, with slowing of the infusion rate. Signs of infusion-related reactions from the use of DOXIL® may include (but are not limited to):
- Back pain
- Tightness in the chest or throat
- Flushed feeling
- Shortness of breath
- Facial swelling
- Dizziness or light-headedness
Tell your doctor or nurse immediately during your infusion if you experience any of the symptoms mentioned bove.
Like other chemotherapies, DOXIL® may severely reduce the number of blood cells. Changes in blood cell counts are generally moderate and reversible in patients with recurrent ovarian cancer treated with DOXIL®. In some patients, blood cell counts may be severely lowered. This can cause other unwanted effects, such as:
- Lowered white blood cell counts (neutropenia) that can lead to fever and infections
- Lowered red blood cell counts (anemia) that may make you feel tired and fatigued (a tired feeling that does not get better with rest)
- Lowered platelets counts (thrombocytopenia) that can reduce your body’s ability to form blood clots. This can cause any bleeding to last longer than usual and may cause you to bruise more easily.
Your doctor will check your blood cell counts regularly and may adjust your dose of DOXIL®.
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®.
How often the skin reactions described in this section occur and how severe they are usually relate to the amount of DOXIL® you are taking and/or the schedule of your DOXIL® doses. Your doctor may delay, reduce, or discontinue your treatment if skin reactions occur.
You may experience a skin reaction called hand-foot syndrome (HFS). This is also called palmar-plantar erythrodysesthesia (PPE). It usually appears on the palms of the hands and soles of the feet. Hand-foot syndrome, when it happens, generally appears after 2 or 3 treatment cycles, but may occur earlier. This reaction can be severe in some patients and may require discontinuation of treatment. Skin-related reactions may also occur on other parts of the body, 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:
- 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
You or a friend or family member should check your body regularly for signs of skin irritation and HFS. If you have numbness or tingling in your hands and feet (peripheral neuropathy) from other treatment(s) or other conditions, you may not feel the symptoms easily. In most patients, HFS is mild and improves in 1 to 2 weeks without needing to delay DOXIL® therapy. However, in some cases, it can be serious and may affect your daily activities. There are things you can do that may help to ease your symptoms.
How often the skin reactions described in this section occur and how severe they are usually relate to the amount of DOXIL® you are taking and/or the schedule of your DOXIL® doses. Your doctor may delay, reduce, or discontinue your treatment.
Another skin-related reaction is stomatitis, a mouth irritation that takes the form of inflammation or sores. Proper care of your mouth and avoiding certain foods and drinks may help manage stomatitis.
Tell your doctor or nurse if you experience any of these common signs and symptoms of stomatitis:
- Mouth sores
- Swelling of the mouth and/or tongue
- Pain or burning in the mouth
- Inability to eat or drink
- Difficulty swallowing
Like other chemotherapies, DOXIL® may cause nausea and vomiting.
Nausea and vomiting may be managed by taking medicines that your doctor or nurse gives you. There are also tips you can use that may help to reduce nausea and vomiting.
Tell your doctor or nurse if you experience either of these symptoms. They may be able to give you medication that can help.
Additional common side effects include:
- Tiredness, weakness, rash, shortness of breath, or mild hair loss
- Loss of appetite
- 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.