Doxorubicin Hydrochloride interactions

Checked as Doxorubicin in this data source.

Full monograph for Doxorubicin Hydrochloride Check it against another medicine

Medicines

630 documented

Severity

Mechanism

Medicines documented to interact with Doxorubicin Hydrochloride, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Adalimumab	Major	Synergy	The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections…	6 sources — open the full entry
Amiodarone Hydrochloride	Major	Synergy	Class IA (e.g., disopyramide, quinidine, procainamide) and class III (e.g., amiodarone, dofetilide, sotalol) antiarrhythmic agents can cause dose-related…	45 sources — open the full entry
Amisulpride	Major	Synergy	Amisulpride can cause dose- and concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the…	3 sources — open the full entry
Arsenic Trioxide	Major	Synergy	Arsenic trioxide can cause QT interval prolongation and complete atrioventricular block. Theoretically, coadministration with other agents that can prolong the…	4 sources — open the full entry
Artemether + Lumefantrine	Major	Synergy	Artemether-lumefantrine may cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…2 documented mechanisms	16 sources — open the full entry
Baricitinib	Major	Synergy	Coadministration of baricitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies…	4 sources — open the full entry
Bevacizumab	Major	Synergy	Coadministration of bevacizumab and anthracyclines may increase the risk of cardiac dysfunction. Bevacizumab and anthracyclines are individually cardiotoxic…	3 sources — open the full entry
Cabozantinib	Major	Synergy	Cabozantinib can cause prolongation of the QT interval.	7 sources — open the full entry
Ceritinib	Major	Synergy	Ceritinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval…	9 sources — open the full entry
Chloroquine Phosphate	Major	Synergy	Chloroquine and hydroxychloroquine can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong…	22 sources — open the full entry
Citalopram Hydrobromide	Major	Synergy	Citalopram can cause dose-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	15 sources — open the full entry
Clozapine	Major	Synergy	Coadministration of clozapine with other agents that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity…	6 sources — open the full entry
Crizotinib	Major	Synergy	Crizotinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT…	6 sources — open the full entry
Deferiprone	Major	Synergy	Coadministration of deferiprone and other drugs that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity…	5 sources — open the full entry
Deucravacitinib	Major	Synergy	Coadministration of deucravacitinib with other immunosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies.	1 sources — open the full entry
Efavirenz	Major	Metabolism	Efavirenz can cause significant QT interval prolongation in patients with the CYP450 2B6 6/6 genotype due to reduced metabolic clearance of the drug stemming…	6 sources — open the full entry
Escitalopram Oxalate	Major	Synergy	Escitalopram can cause dose-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	13 sources — open the full entry
Etanercept	Major	Synergy	The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections…	6 sources — open the full entry
Gatifloxacin	Major	Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…	28 sources — open the full entry
Gatifloxacin + Dexamethasone	Major	Metabolism · Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…2 documented mechanisms	32 sources — open the full entry
Golimumab	Major	Synergy	The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections…	6 sources — open the full entry
Haloperidol	Major	Synergy	Haloperidol can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	14 sources — open the full entry
Hydroxychloroquine Sulphate	Major	Synergy	Chloroquine and hydroxychloroquine can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong…	22 sources — open the full entry
Iloperidone	Major	Synergy	Iloperidone may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	9 sources — open the full entry
Infliximab	Major	Synergy	The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections…	6 sources — open the full entry
Ivabradine	Major	Synergy	Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong…	10 sources — open the full entry
Ivosidenib	Major	Synergy	Ivosidenib can cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive…	6 sources — open the full entry
Lefamulin Acetate	Major	Synergy	Lefamulin may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result…	6 sources — open the full entry
Leflunomide	Major	Synergy	The use of leflunomide with other immunosuppressive or myelosuppressive agents may increase the risk of infections. The risk is thought to extend to…	2 sources — open the full entry
Loteprednol Etabonate + Gatifloxacin	Major	Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…	28 sources — open the full entry
Mifepristone	Major	Synergy	Mifepristone may prolong the QTc interval in a dose-related manner. Theoretically, coadministration with other agents that can prolong the QT interval may…	10 sources — open the full entry
Mifepristone + Misoprostol	Major	Synergy · Unknown	Mifepristone may prolong the QTc interval in a dose-related manner. Theoretically, coadministration with other agents that can prolong the QT interval may…2 documented mechanisms	10 sources — open the full entry
Moxifloxacin HydrochlorideInjection Ophthalmic Tablet	Major	Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…	28 sources — open the full entry
Moxifloxacin Hydrochloride + Dexamethasone	Major	Metabolism · Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…2 documented mechanisms	32 sources — open the full entry
Moxifloxacin Hydrochloride + Xanthan Gum	Major	Synergy	Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically…	28 sources — open the full entry
Nilotinib	Major	Synergy	Nilotinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval…	9 sources — open the full entry
Osimertinib	Major	Synergy	Osimertinib may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	5 sources — open the full entry
Pertuzumab + Trastuzumab	Major	Synergy	The use of trastuzumab and anthracyclines in combination has been associated with a high risk of cardiotoxicity. Trastuzumab and agents in the anthracycline…	5 sources — open the full entry
Ribociclib	Major	Metabolism · Synergy	Ribociclib can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	10 sources — open the full entry
Rotavirus Vaccine	Major	Others	The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of…	9 sources — open the full entry
Selpercatinib	Major	Synergy	Selpercatinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT…	6 sources — open the full entry
Sotalol Hydrochloride	Major	Synergy	Class IA (e.g., disopyramide, quinidine, procainamide) and class III (e.g., amiodarone, dofetilide, sotalol) antiarrhythmic agents can cause dose-related…	45 sources — open the full entry
Sparfloxacin	Major	Synergy	Sparfloxacin may cause dose-related prolongation of the QT interval in some patients. Theoretically, coadministration with other agents that can prolong the QT…	21 sources — open the full entry
Thalidomide	Major	Synergy	Coadministration of thalidomide with glucocorticoids and/or antineoplastic agents in the treatment of malignancy may potentiate the risk of thromboembolism…	20 sources — open the full entry
Tofacitinib	Major	Others	Coadministration of tofacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies…	1 sources — open the full entry
Trastuzumab	Major	Synergy	The use of trastuzumab and anthracyclines in combination has been associated with a high risk of cardiotoxicity. Trastuzumab and agents in the anthracycline…	5 sources — open the full entry
Upadacitinib	Major	Others	Coadministration of upadacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies.	1 sources — open the full entry
Yellow Fever Vaccine	Major	Others	The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of…2 documented mechanisms	19 sources — open the full entry
Ziprasidone	Major	Synergy	Ziprasidone can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…	10 sources — open the full entry
Abametapir	Moderate	Metabolism	Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450…	1 sources — open the full entry

Conditions

Conditions in which Doxorubicin Hydrochloride needs care, as documented in this source.

Bone Marrow Failure Disorders
Major
Doxorubicin induces dose-related myelosuppression, primarily affecting leukocytes. Therapy with doxorubicin should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering doxorubicin and the dosage should be reduced. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended. Doxorubicin is contraindicated in patients with severe persistent drug-induced myelosuppression
8 sources
1. Johnson PJ, Dobbs N, Kalayci C, Aldous MC, Harper P, Metivier EM, Williams R "Clinical efficacy and toxicity of standard dose adriamycin in hyperbilirubinaemic patients with hepatocellular carcinoma: relation to liver tests and pharmacokinetic parameters." Br J Cancer 65 (1992): 751-5
2. Maral RJ, Jouanne M "Toxicology of daunorubicin in animals and man." Cancer Treat Rep 65 Suppl 4 (1981): 9-18
3. Doll DC, Weiss RB "Hemolytic anemia associated with antineoplastic agents." Cancer Treat Rep 69 (1985): 777-82
4. Tan C, Etcubanas E, Wollner N, Rosen G, Gilladoga A, Showel J, Murphy ML, Krakoff IH "Adriamycin--an antitumor antibiotic in the treatment of neoplastic diseases." Cancer 32 (1973): 9-17
5. Carter SK "Adriamycin-a review." J Natl Cancer Inst 55 (1975): 1265-74
6. Bick RL, Fekete LF, Wilson WL "Adriamycin and fibrinolysis." Thromb Res 8 (1976): 467-75
7. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
8. "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
Cardiomyopathies
Major
Myocardial damage, including acute left ventricular failure can occur with doxorubicin. The risk of cardiomyopathy is proportional to the cumulative exposure with incidence rates from 1% to 20% for cumulative doses ranging from 300 mg/m2 to 500 mg/m2 when doxorubicin is administered every 3 weeks. The risk of cardiomyopathy is further increased with concomitant cardiotoxic therapy. Additionally, doxorubicin can also cause arrhythmias, including life-threatening events at any point during treatment. Assess LVEF before and regularly during and after treatment with doxorubicin. Doxorubicin is contraindicated in patients with severe myocardial insufficiency and recent myocardial infarction (past 6 months).
23 sources
1. Krivit W "Adriamycin cardiotoxicity amelioration by alpha-tocopherol." Am J Pediatr Hematol Oncol 1 (1979): 151-3
2. Caviale P, McClellan EL "Adriamycin toxicity. Effects in subsequent anesthesia and surgery." J Kans Med Soc 82 (1981): 553,574
3. Freter CE, Lee TC, Billingham ME, Chak L, Bristow MR "Doxorubicin cardiac toxicity manifesting seven years after treatment. Case report and review." Am J Med 80 (1986): 483-5
4. Speyer JL, Green MD, Dubin N, Blum RH, Wernz JC, Roses D, Sanger J, Muggia FM "Prospective evaluation of cardiotoxicity during a six-hour doxorubicin infusion regimen in women with adenocarcinoma of the breast." Am J Med 78 (1985): 555-63
5. McQuillan PJ, Morgan BA, Ramwell J "Adriamycin cardiomyopathy. Fatal outcome of general anaesthesia in a child with adriamycin cardiomyopathy." Anaesthesia 43 (1988): 301-4
6. Mortensen SA, Olsen HS, Baandrup U "Chronic anthracycline cardiotoxicity: haemodynamic and histopathological manifestations suggesting a restrictive endomyocardial disease." Br Heart J 55 (1986): 274-82
7. Haq MM, Legha SS, Choksi J, Hortobagyi GN, Benjamin RS, Ewer M, Ali M "Doxorubicin-induced congestive heart failure in adults." Cancer 56 (1985): 1361-5
8. Lee BH, Goodenday LS, Muswick GJ, Yasnoff WA, Leighton RF, Skeel RT "Alterations in left ventricular diastolic function with doxorubicin therapy." J Am Coll Cardiol 9 (1987): 184-8
Show all 23 sourcesShow fewer sources
1. Lum BL, Svec JM, Torti FM "Doxorubicin: alteration of dose scheduling as a means of reducing cardiotoxicity." Drug Intell Clin Pharm 19 (1985): 259-64
2. Sperber AD, Cantor AA, Biran H, Keynan A "Selective right ventricular dysfunction following doxorubicin therapy." Isr J Med Sci 23 (1987): 896-9
3. Shapira J, Gotfried M, Lishner M, Ravid M "Reduced cardiotoxicity of doxorubicin by a 6-hour infusion regimen. A prospective randomized evaluation." Cancer 65 (1990): 870-3
4. Porembka DT, Lowder JN, Orlowski JP, Bastulli J, Lockrem J "Etiology and management of doxorubicin cardiotoxicity." Crit Care Med 17 (1989): 569-72
5. Devoy MA, Tomson CR "Fatal cardiac failure after a single dose of doxorubicin in myeloma- associated cardiac amyloid." Postgrad Med J 68 (1992): 69
6. Barendswaard EC, Prpic H, Van der Wall EE, Camps JA, Keizer HJ, Pauwels EK "Right ventricle wall motion abnormalities in patients treated with chemotherapy." Clin Nucl Med 16 (1991): 513-6
7. Lahtinen R, Kuikka J, Nousiainen T, Uusitupa M, Lansimies E "Cardiotoxicity of epirubicin and doxorubicin: a double-blind randomized study." Eur J Haematol 46 (1991): 301-5
8. Fu LX, Waagstein F, Hjalmarson A "A new insight into adriamycin-induced cardiotoxicity." Int J Cardiol 29 (1990): 15-20
9. Steinherz L, Steinherz P "Delayed cardiac toxicity from anthracycline therapy." Pediatrician 18 (1991): 49-52
10. Bristow MR, Thompson PD, Martin RP, Mason JW, Billingham ME, Harrison DC "Early anthracycline cardiotoxicity." Am J Med 65 (1978): 823-32
11. Rinehart JJ, Lewis RP, Balcerzak SP "Adriamycin cardiotoxicity in man." Ann Intern Med 81 (1974): 475-8
12. Benjamin RS, Wiernik PH, Bachur NR "Adriamycin chemotherapy--efficacy, safety, and pharmacologic basis of an intermittent single high-dosage schedule." Cancer 33 (1974): 19-27
13. Lefrak EA, Pitha J, Rosenheim S, Gottlieb JA "A clinicopathologic analysis of adriamycin cardiotoxicity." Cancer 32 (1973): 302-14
14. Carter SK "Adriamycin-a review." J Natl Cancer Inst 55 (1975): 1265-74
15. Billingham ME, Bristow MR, Glatstein E, Mason JW, Masek MA, Daniels JR "Adriamycin cardiotoxicity: endomyocardial biopsy evidence of enhancement by irradiation." Am J Surg Pathol 1 (1977): 17-23
Infections
Major
Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.
39 sources
1. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
2. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories (2002):
3. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb (2001):
4. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):
5. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation (2001):
6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb (2001):
7. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb (2001):
8. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2001):
Show all 39 sourcesShow fewer sources
1. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
2. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
3. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
4. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
5. "Product Information. Fludara (fludarabine)." Berlex Laboratories (2001):
6. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn (2001):
7. "Product Information. Matulane (procarbazine)." Roche Laboratories (2001):
8. "Product Information. DTIC-Dome (dacarbazine)." Bayer (2001):
9. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
10. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc (2001):
11. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company (2001):
12. "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
13. "Product Information. Taxotere (docetaxel)." Rhone Poulenc Rorer (2001):
14. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb (2001):
15. "Product Information. Nipent (pentostatin)." Hospira Inc (2001):
16. "Product Information. Tabloid (thioguanine)." Prasco Laboratories (2001):
17. "Product Information. Xeloda (capecitabine)." Roche Laboratories (2001):
18. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):
19. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome (2001):
20. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
21. "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
22. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn (2001):
23. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation (2001):
24. "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):
25. "Product Information. Halaven (eribulin)." Eisai Inc (2010):
26. "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc (2014):
27. "Product Information. Blincyto (blinatumomab)." Amgen USA (2014):
28. "Product Information. Opdivo (nivolumab)." Bristol-Myers Squibb (2014):
29. "Product Information. Unituxin (dinutuximab)." United Therapeutics Corporation (2015):
30. "Product Information. Empliciti (elotuzumab)." Bristol-Myers Squibb (2015):
31. "Product Information. Pepaxto (melphalan flufenamide)." Oncopeptides Inc. (2021):
Liver Diseases
Major
Doxorubicin is contraindicated in patients with severe hepatic impairment (defined as Child Pugh Class C or serum bilirubin level greater than 5 mg/dL). Doxorubicin is primarily metabolized by the liver and its clearance is reduced in the presence of hepatic dysfunction, increasing the risk for toxicity. Therapy with doxorubicin should be administered cautiously and at a reduced dosage in patients with moderate or mild hepatic function. Close clinical monitoring of hepatic function prior to initiation of doxorubicin therapy is recommended.
3 sources
1. Aviles A, Herrera J, Ramos E, Ambriz R, Aguirre J, Pizzuto J "Hepatic injury during doxorubicin therapy." Arch Pathol Lab Med 108 (1984): 912-3
2. Maral RJ, Jouanne M "Toxicology of daunorubicin in animals and man." Cancer Treat Rep 65 Suppl 4 (1981): 9-18
3. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):

Therapeutic duplication

Drug classes that overlap with Doxorubicin Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

antineoplastic antibiotics
The recommended maximum number of medicines in the 'antineoplastic antibiotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antineoplastic antibiotics' category.
Example product in the source data (US market): Vyxeos

Medicines

Conditions

Bone Marrow Failure Disorders

Cardiomyopathies

Infections

Liver Diseases

Therapeutic duplication

antineoplastic antibiotics