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Daunorubicin Liposome

(daw-no-roo-buh-sin lye-po-soam)

Trade/other name(s): DaunoXome

Why would this drug be used?

Daunorubicin liposome is used to treat Kaposi sarcoma.

How does this drug work?

Daunorubicin liposome belongs to the group of chemotherapy drugs known as anthracycline antibiotics. It is daunorubicin with a special covering made of fat (liposome) that allows the drug to go directly to the cancer and not be damaged by the body's immune system. Daunorubicin liposome slows or stops the growth of cancer cells, causing many of them to die.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have ever been treated for cancer with doxorubicin, epirubicin, idarubicin, mitoxantrone (similar types of chemotherapy), or any other drug that can cause heart damage. Your dose of daunorubicin liposome may need to be adjusted.
  • If you have ever had radiation treatment to the chest. Radiation may cause some damage to the heart, and your doctor may change your daunorubicin liposome dose to reduce the risk of further damage.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. Check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

No serious interactions are known at this time, but this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Daunorubicin liposome is given in a vein over 1 hour, usually every 2 weeks. Tell your nurse right away if you get pain or tightness in your chest, back pain, and/or feel flushed. This can be lessened by slowing or stopping the medicine for a few minutes. You can be given a medicine to stop nausea and/or vomiting. Tell your doctor or nurse if it does not work. Your blood counts will be checked before each treatment. If they are too low, your treatment will be delayed. The dose depends on your size and blood counts, and how well your kidneys and liver work.

Precautions

Daunorubicin liposome is given into the vein (IV). If the drug leaks out of the vein and under the skin, it could damage the tissue, causing pain, ulceration, and scarring. Tell the nurse right away if you notice redness, pain, or swelling at or near the IV.

This drug can cause allergic reactions in some people. Mild reactions usually consist of fever and chills. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), fever or chills, hives (welts), nausea, itching, headache, coughing, shortness of breath, or swelling of the face, eyes, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms as you are being given the drug.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. Try to stay away from people who have recently been vaccinated with a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

Daunorubicin causes the urine to turn reddish for 1 to 2 days after each dose is given. This is normal while your body gets rid of the drug, but may stain your clothes.

Your doctor will probably test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or medicines containing aspirin, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

Daunorubicin liposome can injure the heart muscle when large total doses of this type of drug are given, and can cause congestive heart failure either during or after your treatment. Your doctor will test your heart before you get your first treatment, and then during the treatment. This way, any damage can be found early. During and after your treatment with the drug, it is still important to let your doctor know right away if you notice shortness of breath, swollen feet or ankles, or an irregular heartbeat. These effects can show up months or even years after you get the drug.

Because of how this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would probably be years after you used the drug. If you are getting this drug, your doctor believes this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • low white blood cell count with increased risk of infection*
  • low platelet count with increased risk of bleeding*
  • mild nausea
  • tiredness (fatigue)

Less common

  • back pain, flushing, and chest tightness when drug is first given
  • vomiting
  • loss of appetite
  • diarrhea
  • moderate nausea
  • anemia (low red blood cell count)

Rare

  • mild hair loss
  • difficulty swallowing
  • stomach irritation
  • hemorrhoids
  • enlarged liver
  • dry mouth
  • cavities in teeth
  • heart damage with shortness of breath and swollen feet and ankles, which can happen months or years after treatment*
  • Irregular heartbeat
  • leukemia or myelodysplastic syndrome, which may happen years after treatment*
  • dry skin

*See "Precautions" section for more detailed information.

There are other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1996.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 11/25/2009
Last Revised: 11/25/2009