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Caelyx versus generic doxorubicin

What are the differences among doxorubicin variants: Caelyx, Doxil, Adriamycin (toxicity, effectiveness, etc).  Thank you very much!
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Avatar universal
Thank you very much.
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242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi There,

Doxorubicin (trade name Adriamycin) or hydroxyldaunorubicin is a DNA-interacting drug widely used in chemotherapy. It is an anthracycline antibiotic and structurely closely related to daunomycin, and also intercalates DNA. It is commonly used in the treatment of a wide range of cancers.

The drug is administered by injection, and may be sold under the brand names Adriamycin PFS, Adriamycin RDF, or Rubex.[2] Doxil is a liposome-encapsulated dosage form of doxorubicin made by Ben Venue Laboratories for Johnson & Johnson. The main benefits of this form are a reduction in cardiotoxicity

DOXIL is a reformulated version of doxorubicin. DOXIL takes the active agent doxorubicin and places it into a fat bubble called a liposome and another layer of hair-like strands made from methoxypolyethylene glycol—a type of rubber. This coating allows DOXIL to evade detection and destruction by the immune system, which increases the time the drug is in the body. The majority of the drug stays inside the liposome while in the blood (at least 90%). Therefore, DOXIL has more time to reach the tumor tissue, where the medication slowly leaks out. However, DOXIL may also leak out and affect normal tissue.

and from the following link: http://www.cancerhelp.org.uk/help/default.asp?page=6590

Liposomal Doxorubicin (Caelyx, Myocet, Doxcil)
This page tells you about the possible side effects of liposomal doxorubicin.  You may hear it called by the brand name Caelyx.  There are sections on


Liposomal doxorubicin is used to treat some types of cancers, including breast and ovarian cancer and a type of sarcoma called Kaposi’s sarcoma.  Liposomal doxorubicin is the chemical name for the drug.  The most common brand name for this drug in the UK is Caelyx.  There is also a brand called Myocet.  Doxil is mainly used in the USA.

This drug contains the chemotherapy drug doxorubicin (Adriamycin) 'wrapped up' in a fatty covering called a liposome.  This allows the doxorubicin to stay in the bloodstream longer, so that more of the drug reaches the cancer cells.  It has fewer side effects on healthy cells than doxorubicin because the fatty covering acts as a barrier.

Liposomal doxorubicin comes as a light red liquid that you have through a drip (infusion) into a vein.  You may have a fine tube (cannula) put into a vein each time you have treatment.  Or you may have a semi-permanent central line put into a vein near your collarbone at the beginning of your treatment course.


Common side effects

Fatigue - for many people this is the most troublesome side effect of all.  Tiredness often carries on after treatment has ended.  Most people find their energy levels are back to normal from 6 months to a year after their treatment finishes.            
Temporary effect on the bone marrow.  The bone marrow makes blood cells and a drop in its function can cause

- An increased risk of getting infections.  
- Tiredness and breathlessness.  This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia.  You may need a blood transfusion to treat anaemia.

- Getting bruises more easily.  This is due to a drop in the number of platelets produced by your bone marrow.  You may have lots of tiny red spots or bruises on your arms or legs.  You may have nosebleeds or notice your gums bleed when you brush your teeth.


Feeling or being sick happens in about 1 in 3 patients, although it is usually mild and controlled with anti-sickness injections and tablets.      
Sore mouth or mouth ulcers occur in up to 1 in 3 people treated        
Swelling, pain or redness of palms of the hands or soles of the feet is usually mild, but affects up to 4 out of 10 people .  This is called palmer-planter syndrome.  You may have tingling, numbness, pain, dryness, or a rash.  Tell your doctor if you have this - you can be given vitamin B6 (pyridoxine) to help control this effect.  It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
Red or orange urine within 1 or 2 days of treatment – this is the colour of the drug and is nothing to worry about

Occasional side effects

Diarrhoea  - you should drink plenty of fluids.  If it becomes severe or persistent you could get dehydrated so you should tell your doctor or nurse.      
Sensitivity to the sun - you should cover up and stay in the shade while you are having treatment with this drug and if you must be exposed to the sun, use a high factor sun cream        
Temporary hair loss or hair thinning may begin 2 – 5 weeks after treatment starts  
An allergic reaction happens in up to 1 in 10 (10%) people while they are having the drug, causing flushing, breathlessness, swelling of the face, chills, back pain, a headache, or chest tightness.  Let your nurse know immediately if you have any of these.    
Rare side effects


While you are having the chemotherapy infusion, doxorubicin may leak into the body tissues around the vein and cause a sore to develop.  - Stinging or burning around the vein
- Leakage of fluid from the drip site
- Red or swollen drip site after your treatment

Black or brown discoloration in the creases of your skin is particularly common in children (although this drug is not often used with children)        
With liposomal doxorubicin, skin treated with radiotherapy in the past can become dry and flaky and you may have pain and burning similar to sun burn        
Liposomal doxorubicin can cause temporary damage to the muscles of the heart, which may change the rhythm of the heartbeat.  In most cases this will go back to normal after the treatment is completed.  Your heart will be checked before you start treatment.    
Loss of fertility - you may not be able to get pregnant or father a child after treatment with this drug.  
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