Incidence and severity was highest when used with anthracycline-containing chemotherapy regimens.
paclitaxel increases levels of doxorubicin liposomal by decreasing renal clearance. Inreased risk of myelosuppression. Each 10 ml Lipo-Dox vial contains 20mg of doxorubicin HCl as a concentration of 2mg/ml. Share cases and questions with Physicians on Medscape consult. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. <> x}Rj0+tl/ch\>tn?SA-Y9$Mbf"MR7/'f-XK%Lp{8HhvANy04QY'kf,=0Rw:UD~I+93f
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Use Caution/Monitor. phenytoin will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. dronedarone will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Use Caution/Monitor. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Notify your doctor promptly if you experience swelling, pain, redness, dryness, peeling, blisters, or tingling/burning of the hands/feet. Use Caution/Monitor. nifedipine will decrease the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
Fostemsavir inhibits BCRP transporters. voriconazole will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
unknown mechanism. Use Caution/Monitor.
Serious - Use Alternative (1)saquinavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)desvenlafaxine will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. To view formulary information first create a list of plans. Use Caution/Monitor. lapatinib will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)rifabutin will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Comment: Concomitant administration of zidovudine and doxorubicin should be avoided since an antagonistic relationship has been demonstrated in vitro. Other (see comment).
If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis. Applies only to oral form of both agents. lapatinib will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Use Caution/Monitor. Please confirm that you would like to log out of Medscape. Minor/Significance Unknown.
endobj Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Use Caution/Monitor. xref
rolapitant will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism. See also Side Effects section.Your doctor will closely monitor you while you are being treated with this medication.Different types of this medication work in different ways. Use Caution/Monitor. Avoid or Use Alternate Drug. 0000124455 00000 n
Monitor Closely (1)amiodarone will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (1)rolapitant will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. 0000100233 00000 n
Comment: Mechanism: inhibition of phosphorylation process. Use Caution/Monitor. Use Caution/Monitor. Do not switch types of this medication without your doctor's permission. Either increases toxicity of the other by unknown mechanism. ritonavir will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. In clinical studies, an increase of 21% and 47% and no changes in the AUC of doxorubicin were observed with coadministration of sorafenib 400 mg twice daily. commonly, these are "preferred" (on formulary) brand drugs.
Use Caution/Monitor. Your risk of developing heart problems depends on your dose, medical history (including previous heart disease, radiation therapy in the chest area), and previous use of this and other drugs (including daunorubicin and cyclophosphamide). Coadministration of doxorubicin and calcium channel blockers may increase the risk of doxorubicin cardiotoxicity. Use Caution/Monitor. Use caution when switching patients from long-acting therapies with immune effects. Modify Therapy/Monitor Closely.
Asia's one-stop resource for medical news, clinical reference and education. belzutifan will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. desvenlafaxine will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor Closely (2)doxorubicin liposomal decreases levels of fosphenytoin by increasing metabolism.
trazodone will decrease the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. conivaptan will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Avoid or Use Alternate Drug. cyclosporine will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. doxorubicin liposomal, tofacitinib. P-gp inducers reduce systemic exposure of dabigatran. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary. Monitor Closely (2)phenobarbital will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. 175 0 obj fedratinib will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism.
Modify Therapy/Monitor Closely. Monitor Closely (1)doxorubicin liposomal will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. You may report side effects to Health Canada at 1-866-234-2345. This drug is available at a middle level co-pay. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. Use Caution/Monitor. nafcillin will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Notify your doctor right away if redness, pain, or swelling occur at or near the injection site.If this medication touches your skin, immediately and completely wash skin with soap and water. Use Caution/Monitor. enzalutamide will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. doxorubicin liposomal will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 0000002023 00000 n
Consider increasing CYP3A substrate dose if needed. Use Caution/Monitor. Monitor Closely (3)cyclosporine will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. dronedarone will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. itraconazole will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter.
0000008873 00000 n
Use Caution/Monitor.
This effect was not observed with istradefylline 20 mg/day. erythromycin ethylsuccinate will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Tell your doctor right away if you develop any signs of infection (such as sore throat that doesn't go away, fever, chills), unusual tiredness, or easy bleeding/bruising.
ritonavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
restrictions. Modify Therapy/Monitor Closely.
apalutamide will decrease the level or effect of doxorubicin liposomal by increasing elimination. Use Caution/Monitor. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation. <>stream
doxorubicin liposomal decreases effects of sipuleucel-T by pharmacodynamic antagonism.
Monitor Closely (2)erythromycin stearate will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. nefazodone will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Avoid or Use Alternate Drug. doxorubicin, pegylated liposomal intravenous. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration. Caution is warranted. 181 0 obj Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis. unknown mechanism.
Monitor for doxorubicin-induced cardiovascular toxicity. rifapentine will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dasatinib will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dosage of CYP3A4 substrates, if clinically indicated. cyclosporine will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Modify Therapy/Monitor Closely. Lipo-Dox, as a monotherapy, is indicated for the treatment of metastatic breast cancer. Monitor Closely (1)nelfinavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 0000013592 00000 n
0000001483 00000 n
Monitor Closely (1)doxorubicin liposomal decreases effects of stavudine by Other (see comment). Modify Therapy/Monitor Closely. Monitor Closely (1)doxorubicin liposomal will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Modify Therapy/Monitor Closely. Minor/Significance Unknown.
Monitor Closely (1)streptozocin increases levels of doxorubicin liposomal by decreasing metabolism. doxorubicin liposomal increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Use Caution/Monitor. If any of these effects continue or worsen, notify your doctor or pharmacist.This medication may give a reddish-orange color to your urine, tears, and sweat.
endobj Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. Use Caution/Monitor.elagolix will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Immunosuppressive drugs may reduce the immune response to influenza vaccine. Minor/Significance Unknown. nicardipine will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. levoketoconazole will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Fexinidazole inhibits CYP3A4.
The clinical importance of these findings is unknown.
Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Given the difference in pharmacokinetic profiles and dosing schedules, Lipo-Dox should not be used interchangeably with other formulations of doxorubicin hydrochloride.
Use Caution/Monitor. Minor/Significance Unknown. P-gp inducers reduce systemic exposure of dabigatran. Use Caution/Monitor. Minor/Significance Unknown. encorafenib, doxorubicin liposomal. Treatments of acute reaction of overdosage in the severely myelosuppressed patient include hospitalization, antibiotics, platelet and granulocyte transfusions and symptom relief of mucositis. Use Caution/Monitor. <>stream
Minor/Significance Unknown. Caution should be exercised in the concomitant use of drugs known to interact with standard doxorubicin HCl. Comment: Combination may increase risk of myelosuppression.
If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Serious - Use Alternative (1)fexinidazole will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Comment: Combination may increase risk of myelosuppression. nefazodone will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. grapefruit will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Like other doxorubicin HCl preparations, pegylated liposomal doxorubicin may potentiate the toxicity of other anti-cancer therapies. doxorubicin liposomal decreases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. endobj Use Caution/Monitor. startxref
endobj Use Caution/Monitor.
Use Caution/Monitor. Use Caution/Monitor.doxorubicin liposomal decreases levels of phenytoin by increasing metabolism. Monitor Closely (1)nevirapine will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Monitor Closely (2)rifampin will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Seek immediate medical attention.Family members and caregivers should take precautions (such as wear gloves) to prevent contact with the patient's urine or other body fluid for at least 5 days after treatment. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: digoxin, progesterone, streptozocin, stavudine, trastuzumab, zidovudine.Other medications can affect the removal of doxorubicin from your body, which may affect how doxorubicin works. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. Use Caution/Monitor.
Monitor Closely (1)indinavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. <> apalutamide will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)quinupristin/dalfopristin will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. SIDE EFFECTS: See also Warning section.Body aches/pains, headache, nausea, vomiting, constipation, diarrhea, stomach upset, and loss of appetite may occur. Use Caution/Monitor. Minor (1)artemether/lumefantrine will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Modify Therapy/Monitor Closely.
Contact the applicable plan Use Caution/Monitor. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity. Minor/Significance Unknown. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day. Monitor Closely (2)ritonavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 168 0 obj lorcaserin will increase the level or effect of doxorubicin liposomal by affecting hepatic enzyme CYP2D6 metabolism. Monitor for doxorubicin-induced cardiovascular toxicity. prescription products. endobj If unavoidable, reduce CYP3A substrate dose according to product labeling. Information last revised December 2021. MUGA or echocardiogram) prior to initiation of therapy, during treatment to detect acute changes, and after treatment to detect delayed cardiomyopathy, Administer therapy to patients with a history of cardiovascular disease only when the potential benefit of treatment outweighs the risk, Ensure that medications to treat infusion-related reactions and cardiopulmonary resuscitative equipment are available for immediate use prior to initiation of treatment, Initiate infusions at a rate of 1 mg/min and increase rate as tolerated, Withhold therapy for Grade 1, 2, or 3 infusion-related reactions and resume at a reduced infusion rate, Discontinue therapy for serious or life-threatening infusion-related reactions, Advise females of reproductive potential to use effective contraception during and for 6 months after treatment, Therapy may damage spermatozoa and testicular tissue, resulting in possible genetic fetal abnormalities; males with female sexual partners of reproductive potential should use effective contraception during and for 6 months after treatment, In females of reproductive potential, therapy may cause infertility and result in amenorrhea; premature menopause can occur; recovery of menses and ovulation is related to age at treatment, In males drug may result in oligospermia, azoospermia, and permanent loss of fertility; sperm counts have been reported to return to normal levels in some men; this may occur several years after end of therapy, In animal reproduction studies, therapy was embryotoxic in rats and abortifacient in rabbits following intravenous administration during organogenesis at doses approximately 0.12 times the recommended clinical dose, Available human data do not establish presence or absence of major birth defects and miscarriage related to use of doxorubicin hydrochloride during 2nd and 3rd trimesters; advise pregnant women of potential risk to a fetus. ranolazine will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Either increases effects of the other by immunosuppressive effects; risk of infection. Comment: Potential for increased risk of cardiotoxicity (CHF). Use Caution/Monitor. Monitor Closely (1)doxorubicin liposomal increases toxicity of cyclophosphamide by unspecified interaction mechanism. Use Caution/Monitor.
Monitor Closely (2)fedratinib will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nelfinavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consult your pharmacist or local waste disposal company. This website also contains material copyrighted by 3rd parties. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects. Serious - Use Alternative (1)tipranavir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Use Caution/Monitor. This drug is available at a higher level co-pay. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911.
erythromycin base will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases toxicity of the other by unknown mechanism. Avoid prolonged sun exposure, tanning booths and sunlamps. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .Serious - Use Alternative (1)trastuzumab, doxorubicin liposomal. Use Caution/Monitor. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. Tell the doctor right away if you notice wheezing or trouble breathing in the child.Very rarely, people with cancer who are treated with this type of medication have developed other cancers (such as secondary leukemia, oral cancer). Use Caution/Monitor. Use Caution/Monitor. Adjust dose according to prescribing information if needed. doxorubicin liposomal, denosumab. Minor/Significance Unknown.
endstream Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg. dexamethasone will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. CYP3A4 substrates may require dosage adjustment. Musculoskeletal and connective tissue disorders: Muscle spasms, Respiratory, thoracic and mediastinal disorders: Pulmonary embolism (in some cases fatal), Hematologic disorders: Secondary acute myelogenous leukemia, Skin and subcutaneous tissue disorders: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, lichenoid keratosis, History of severe hypersensitivity to doxorubicin, including anaphylaxis, Serious and sometimes life-threatening infusion-related reactions reported; ensure that medications to treat infusion-related reactions and cardiopulmonary resuscitative equipment are available for immediate use prior to initiation (see Black Box Warnings), Incidence of hand-foot syndrome in 1 trial was 51%, including 24% grade 3 or 4 toxicity (see Dosage Modifications), Secondary oral cancers, primarily squamous cell carcinoma, have been reported, Based on animal data, can cause fetal harm when administered to pregnant women, Based on findings in animals and its mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; avoid use during the 1st trimester, Verify the pregnancy status of females of reproductive potential prior to initiating therapy, Not known whether drug is present in human milk; because many drugs, including anthracyclines, are excreted in human milk and because of the potential for serious adverse reactions in breastfed infants from therapy, discontinue breastfeeding during treatment.
Modify Therapy/Monitor Closely. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Use Caution/Monitor.
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streptozocin increases levels of doxorubicin liposomal by decreasing metabolism.
Compare formulary status to other drugs in the same class. hydrocortisone will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Monitor Closely (1)belatacept and doxorubicin liposomal both increase immunosuppressive effects; risk of infection. doxorubicin liposomal will decrease the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect. Monitor Closely (1)doxorubicin liposomal increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If anthracyclines are used, carefully monitor cardiac function. Minor/Significance Unknown. Manage and view all your plans together even plans in different states. Avoid or Use Alternate Drug. Monitor Closely (1)doxorubicin liposomal and olaparib both increase pharmacodynamic synergism. Avoid pressure on elbows, knees, and soles of feet (such as leaning on elbows, kneeling, long walks). Serious - Use Alternative (1)abametapir will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)nefazodone will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter.
Use Caution/Monitor. oxcarbazepine will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors.
lipodox package insert
