Antharin-50 Dosage/Direction for Use

The total doxorubicin dose per cycle may differ according to its use within a specific treatment regimen (e.g. given as a single agent or in combination with other cytotoxic drugs) and according to the indication.
The solution is given via the tubing of a freely running intravenous infusion, taking not less than 3 minutes and not more than 10 minutes over the injection. This technique minimises the risk of thrombosis or perivenous extravasation which can lead to severe cellulitis, vesication and necrosis. A direct push injection is not recommended due to the risk of extravasation, which may occur even in the presence of adequate blood return upon needle aspiration.
Dosage is usually calculated on the basis of body surface area. As a single agent, the recommended standard starting dose of doxorubicin per cycle in adults is 60-75 mg/m² of body surface area. The total starting dose per cycle may be given as a single dose or divided over 3 successive days or in divided doses given on days 1 and 8. Under conditions of normal recovery from drug-induced toxicity (particularly bone marrow depression and stomatitis), each treatment cycle can be repeated every 3 to 4 weeks. If it is used in combination with other antitumour agents having overlapping toxicity, the dosage of doxorubicin may need to be reduced to 30-60 mg/m² every three weeks.
If dosage is calculated on the basis of body weight, it has been shown that giving doxorubicin as a single dose every three weeks greatly reduces the distressing toxic effect, mucositis. However, there are still some who believe that dividing the dose over three successive days (0.4-0.8 mg/kg or 20-25 mg/m² on each day) gives greater effectiveness though at the cost of higher toxicity. If dosage is to be calculated on the basis of body weight, 1.2-2.4 mg/kg should be given as a single dose every three weeks.
Administration of doxorubicin in a weekly regimen has been shown to be as effective as the 3-weekly regimen. The recommended dosage is 20 mg/m² weekly, although, objective responses have been seen at 16 mg/m². Weekly administration leads to a reduction in cardiotoxicity.
Dosage may also need to be reduced in children, obese patients and the elderly.
Lower starting doses or longer intervals between cycles may need to be considered for heavily pre-treated patients, or patients with neoplastic bone marrow infiltration.
Hepatic dysfunction: If hepatic function is impaired, doxorubicin dosage should be reduced according to the following table: See table.

Click on icon to see table/diagram/image

Doxorubicin should not be administered to patients with severe hepatic impairment.
Or as prescribed by the physician.