Doxorubicin HCl

What is this medication for?

• The workhorse antineopptic: lymphomas (CHOP), carcinomas, leukemias, sarcomas — alone or in combination

How is it given?

This medication is normally given by your veterinary team (in clinic or hospital).

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• Myelosuppression (neutropenic nadir) (Dose-limiting acutely)
• Gastroenteritis, mouth sores, alopecia (breed-dependent) (Common)
• Immediate hypersensitivity (infusion) (Primarily dogs; potentially brand-specific (histamine-release))

Worth a phone call to your veterinarian

• Cumulative cardiotoxicity (dilated cardiomyopathy) (Risk ↑ >240 mg/m²; predisposed breeds: Doberman, Great Dane, Rottweiler, Boxer — monitor carefully)
• Nephrotoxicity (Monitor renal values before/during therapy)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Trouble breathing, collapse, seizures, severe vomiting or diarrhea, facial swelling, or pale gums

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Myelosuppression, impaired cardiac function, prior cumulative-dose ceiling (incl. daunorubicin), hyperuricemia
• has or has had: Hepatic impairment (dose adjust); cardiomyopathy-predisposed breeds; cats = renal watch

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Other antineoplastics
  • Calcium-channel blockers
  • Cyclophosphamide
  • Dexrazoxane
  • Vaccines/live products

Storage and handling

Chemotherapy handling: gloves/protective clothing for prep/administration; serious vesicant — extravasation causes ulceration/tissue death. Extravasation treatments per human protocols (dexrazoxane; topical dimethyl sulfoxide per Plumb's discussion).

Good to know

• 240 mg/m² is the lifetime line (≈8 doses at 30 mg/m²) — track it like a bank account; the "Adriamycin heart" is irreversible dilated cardiomyopathy.
• Same drug, two species-specific organs at risk: dog = heart, cat = kidney.
• Lethal dose reported at 72 mg/m² in dogs — a single 2.4× dosing error; mg/m² discipline again.
• Slow into a vein over ≥10 min through a perfectly placed, free-flowing catheter; watch the site constantly — doxorubicin extravasation is the feared tissue injury of veterinary chemo.