Doxil (doxorubicin)

Doxil is a type of cancer chemotherapy drug known as an anthracycline. Anthracyclines kill tumor cells by damaging their DNA and preventing its repair. Doxil is a more recent formulation of an older chemotherapy agent called doxorubicin (Adriamycin), which was first approved by the U.S. Food and Drug Administration (FDA) in 1974.

How Is Doxil Used?

DOXIL®  was approved in combination with Velcade® (bortezomib) for the treatment of patients with multiple myeloma who have not previously received bortezomib and have received at least one prior therapy. It is an intravenous (IV, into the vein) medication prescribed by your doctor.

Doxil is also known as doxorubicin HCl liposome injection, or pegylated liposomal doxorubicin (PLD). It is distributed by Janssen Products, LP in the United States. Doxil is also approved for the treatment of patients with ovarian cancer and for patients with AIDS-related Kaposi’s sarcoma.

Warnings and Precautions

Doxil can cause serious and possibly permanent heart-related side effects that may lead to congestive heart failure. Inform your doctor of any history of heart disease, radiation to your chest, or prior anticancer therapy. Your doctor will monitor your heart function.

Infusion-related reactions may occur during administration of Doxil. Tell your doctor if you have any symptoms during infusion, including flushing, shortness of breath, facial swelling, headaches, chills, back pain, chest pain, tightness in your chest or throat, tachycardia (rapid heart beat), pruritus (itching), rash, cyanosis (skin turning blue due to lack of oxygen), syncope (fainting), bronchospasm (tightening of the muscles that line the airways of your lungs), asthma, apnea (stop breathing) and hypotension (low blood pressure). For most patients, these symptoms have resolved within several hours to a day of the infusion. Slowing of the infusion rate can help. However, in some cases, these reactions may be serious, life-threatening, or even fatal.

Doxil may severely reduce the number of blood cells (red blood cells, white blood cells, and cells that prevent bleeding called platelets) in your body that may potentially increase risk of infections, anemia, and bleeding. Speak to your doctor if you notice any changes in your health such as a new onset fever or symptoms of infection. Your doctor will monitor your blood laboratory results.

Hand-Foot Syndrome may occur while taking Doxil. This may lead to tingling or burning, redness, flaking, bothersome swelling, small blisters, or small sores on palms of hands or soles of feet. In certain cases, this reaction can be more severe leading to serious infections, interfering with walking and other daily activities.

Cases of secondary oral cancer have been reported in people who had taken Doxil for more than one year. The oral cancer was diagnosed during treatment and up to 6 years after the last dose. Your doctor will examine you at regular times for the signs and symptoms of oral cancer.

If you are pregnant, planning to become pregnant, or nursing, inform your doctor. Doxil can cause fetal harm. Nursing should be discontinued during treatment with Doxil. Females and males of reproductive potential should use effective contraception during and for 6 months following treatment with Doxil. Doxil may cause temporary or permanent infertility.

Possible Side Effects

The most common side effects reported in greater than 20% of patients treated with Doxil  are weakness, tiredness, fever, nausea, vomiting, stomatitis (painful redness, swelling, or sores in the mouth), diarrhea, constipation, loss of appetite, hand-foot syndrome, rash, low white blood cell count, low platelet count, and anemia. Tell your doctor if you experience these or other side effects.

In the treatment of multiple myeloma, nerve damage called peripheral neuropathy, which may lead to pain, numbness, burning sensation, tingling, and more serious symptoms, was reported in > 40% of patients. Be sure to tell your doctor immediately if you experience any of these or other symptoms.

Following administration, Doxil may turn urine and other bodily fluids a reddish-orange color. This is not toxic anddue to the color of Doxil and will go away as the drug leaves the body.

Your doctor may prescribe anti-nausea medications before or during your Doxil treatment.


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website. 

Last Medical Content Review: August 31, 2021

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