1.2 TO 2.4 MG/KG/BODY WT. OR 60-75 MG/SQR/METER OF BODY SURFACE GIVEN AS A SINGLE DOSE EVERY 3 WEEKS BY SLOW I.V. INJECTION.
DOXORUBICIN HYDROCHLORIDE IS GIVEN BY INTRAVENOUS INJECTION OF A SOLUTION IN SODIUM CHLORIDE 0.9% INTO A FAST-RUNNING INFUSION OF SODIUM CHLORIDE 0.9% OR GLUCOSE 5% OVER 3 MINUTES OR MORE. WHEN USED AS A SINGLE AGENT, THE DOSE IS 60 TO 75 MG/M2, OR 1.2 TO 2.4 MG/KG, ONCE EVERY 3 WEEKS. ALTERNATIVELY, DOSES OF 20 TO 25 MG/M2 HAVE BEEN GIVEN DAILY FOR 3 DAYS EVERY 3 WEEKS, ALTHOUGH DIVIDING THE DOSE IN THIS WAY MAY INCREASE THE INCIDENCE OF MUCOSITIS. A REGIMEN OF 20 MG/M2 AS A SINGLE WEEKLY DOSE MAY BE USED, AND IS REPORTED TO BE ASSOCIATED WITH A LOWER INCIDENCE OF CARDIOTOXICITY.
DOSES MAY NEED TO BE REDUCED IF DOXORUBICIN IS GIVEN WITH OTHER ANTINEOPLASTICS: A DOSE OF 30 TO 40 MG/M2 EVERY 3 WEEKS HAS BEEN SUGGESTED.
THE MAXIMUM TOTAL DOSE SHOULD NOT EXCEED 450 TO 550 MG/M2; IN PATIENTS WHO HAVE RECEIVED RADIOTHERAPY TO THE CHEST, OR OTHER CARDIOTOXIC DRUGS, IT MAY BE ADVISABLE TO FURTHER LIMIT THE TOTAL DOSE.
IN THE MANAGEMENT OF AIDS-RELATED KAPOSI'S SARCOMA PEGYLATED LIPOSOMAL DOXORUBICIN HYDROCHLORIDE IS GIVEN IN A DOSE OF 20 MG/M2 INFUSED OVER 30 MINUTES ONCE EVERY 2 TO 3 WEEKS. FOR THE TREATMENT OF BREAST AND OVARIAN CANCERS, THE SUGGESTED DOSE OF THIS LIPOSOMAL FORMULATION IS 50 MG/M2 INFUSED OVER 1 HOUR ONCE EVERY 4 WEEKS. IN THESE THREE CONDITIONS, TREATMENT SHOULD BE CONTINUED FOR AS LONG AS THE PATIENT RESPONDS SATISFACTORILY AND TOLERATES TREATMENT. THE PEGYLATED LIPOSOMAL FORMULATION SHOULD BE DILUTED ONLY WITH GLUCOSE 5%.
A NON-PEGYLATED LIPOSOMAL FORMULATION IS ALSO AVAILABLE AND CONTAINS A DOXORUBICIN CITRATE COMPLEX PREPARED WITH THE AID OF DOXORUBICIN HYDROCHLORIDE. IT IS GIVEN IN THE TREATMENT OF METASTATIC BREAST CANCER IN DOSES EQUIVALENT TO DOXORUBICIN HYDROCHLORIDE 60 TO 75 MG/M2 EVERY 3 WEEKS, WITH CYCLOPHOSPHAMIDE. DOSES ARE GIVEN BY INTRAVENOUS INFUSION OVER 1 HOUR, DILUTED IN SODIUM CHLORIDE 0.9% OR GLUCOSE 5% TO A FINAL CONCENTRATION OF 0.4 TO 1.2 MG/ML DOXORUBICIN.
BLOOD COUNTS SHOULD BE MADE ROUTINELY DURING TREATMENT WITH DOXORUBICIN AND CARDIAC FUNCTION SHOULD BE MONITORED AT REGULAR INTERVALS FOR EARLY SIGNS OF CARDIOTOXICITY.
DOXORUBICIN HYDROCHLORIDE HAS ALSO BEEN INSTILLED INTO THE BLADDER IN THE LOCAL TREATMENT OF MALIGNANT NEOPLASMS. FOR THIS PURPOSE 50 ML OF A 1 MG/ML SOLUTION MAY BE INSTILLED INTO THE BLADDER FOR ONE HOUR ONCE A MONTH. DOXORUBICIN HAS BEEN GIVEN INTRA-ARTERIALLY.