Pegylated liposomal doxorubicin is an anticancer drug that belongs to anthracycline antibiotics. The FDA approved it in 1995 for treating certain cancers and other diseases.

Pegylated liposomal doxorubicin is used as a monotherapy for patients with metastatic breast cancer, with an increased cardiac risk associated with conventional doxorubicin. It is also indicated for advanced ovarian carcinoma in women who have failed standard first-line therapy (Platinum-and paclitaxel- based chemotherapy is the current standard first-line treatment regimen). It is also used to treat AIDS-related Kaposi’s sarcoma (KS) in patients with low CD4 counts (<200 CD4 lymphocytes/mm3 ) and to treat extensive mucocutaneous or visceral disease in patients who have not responded to previous cancer therapy with other medicines or whose disease has worsened despite the therapy. Other uses include combining bortezomib to treat patients with multiple myeloma who have not previously received bortezomib and have received at least one prior therapy.

The drug should be administered only by physicians experienced with cancer chemotherapy. Your physician will determine the dose and frequency of administration based on the type of cancer and severity of the disease. Generally, for breast and ovarian cancer, the medicine is administered intravenously at a dose of 50 mg/m2 body surface once every 4 weeks for at least 4 courses. For treating AIDS-Kaposi Sarcoma, the drug is administered intravenously at a dose of 20 mg/m2 body surface once every two- to- three weeks only after the failure of prior systemic chemotherapy or intolerance to such therapy. For treating multiple myeloma, first bortezomib is administered at a dose of 1.3 mg/m2 as intravenous bolus on days 1, 4 , 8 and 11, every three weeks, then pegylated liposomal doxorubicin 30 mg/m2 should be administered as a 1-hr intravenous infusion on day 4 following bortezomib.

The common side effects that occur after the administration of pegylated liposomal doxorubicin include a decrease in red blood cells, white blood cells, and platelets,  nausea and vomiting, pain and tenderness, Hand-foot skin reactions where the palms of your hands and soles of your feet may tingle, become red, numb, painful, or swollen, Dry and itchy skin, skin rashes, diarrhea, constipation, mouth sores and bleeding of gums, loss of appetite and weight loss. Some serious but rare side effects include infusion reactions such as shortness of breath, dizziness and excessive sweating, hair loss, and muscle or joint pain. Inform your doctor if you face any symptoms after the initiation of treatment.

Pegylated liposomal doxorubicin is intended to cause severe congestive heart failure and heart muscle disease. The drug should be administered carefully in patients with a history of cardiovascular disease, and cardiac function should be monitored regularly during the therapy. The drug has been shown to cause acute infusion reactions such as flushing, shortness of breath, facial swelling, headache, chills, chest pain, back pain, tightness in the chest and throat, fever, increased heart rate, rash, decreased blood pressure, bluish discoloration of the skin, and dizziness. If you face any of the symptoms, notify your healthcare professional immediately. The drug is reported to cause fetal abnormalities; it is not advisable to use it if you are pregnant or plan to get pregnant.

The drug may cause decreased bone marrow activity. It is advisable to monitor complete blood counts regularly during the therapy and watch for infections. Hand-foot syndrome has been reported with the usage of pegylated liposomal doxorubicin. Notify your doctor promptly if you experience swelling, pain, redness, dryness, peeling, blisters, or tingling/burning of the hands/feet. The symptoms can worsen by heat/pressure on your hands/feet. The drug may cause allergic reactions; notify your doctor if you see any signs of rash, itchy skin, redness, Swelling of your lips or tongue, sudden cough, and low blood pressure. Inform your physician if you have heart disease, gastrointestinal disease, kidney disease, liver disease, lung disease, blood/bleeding problems, or infection and about all the other prescribed, over-the-counter medicines, vitamins, nutritional supplements, or herbal medications you take. This medication may give a reddish-orange color to your urine, tears, and sweat. This is a normal drug effect and should not be mistaken for blood in your urine. Temporary hair loss may occur.

Avoid prolonged sun exposure and unnecessary heat exposure (such as hot dishwater and long hot baths). Avoid pressure on elbows, knees, and soles of feet (such as leaning on elbows, kneeling, and long walks). Wear loose clothing. Keep this medicine out of sight and reach of children. Store the tablets at room temperature. Avoid keeping the tablet in direct sunlight or excessive moisture. Pegylated liposomal doxorubicin may cause dizziness. If you are affected by this side effect, do not drive, use machinery, or do anything that needs alert until you can do it safely.

1. Green AE, Rose PG. Pegylated liposomal doxorubicin in ovarian cancer. International journal of nanomedicine. 2006;1(3):229-239. Accessed December 24, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426807/#:~:text=Mechanism%20of%20action&text=The%20doxorubicin%20molecules%20in%20pegylated
2. Caelyx (Pegylated Liposomal Doxorubicin Hydrochloride Injection): Uses, Dosage, Side Effects, Interactions, Warning. RxList. Published May 27, 2021. Accessed December 24, 2022. https://www.rxlist.com/caelyx-drug.htm#indications
3. HIGHLIGHTS of PRESCRIBING INFORMATION. Accessed December 24, 2022. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/050718s029lbl.pdf
4. Tripathi KD. Essentials of Medical Pharmacology. 8th ed. Jaypee Brothers Medical Publishers; 2019:916-917.

The drug information on this page is not a substitute for medical advice. It is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you can receive this treatment.