PREVENTION OF CARDIOTOXICITY

1. Limiting the cumulative dose in each patient to <550mg/m2.

2. Use of doxorubicin analogs in patients with underlying cardiac dysfunction, examples:

Idarubicin
Epirubicin
3. Infusion over several hours, example:
Continuous infusion
4. Administration in combination with cardioprotective agents, example:
Dexrazoxane: Iron-chelating agent, to decrease the cardiotoxic effect of
doxorubicin by blocking the generation of free radicals.
Doxorubicin should be given within 30 minutes of giving dexrazoxane.
5. Possible use of liposomal-encapsulated doxorubicin in patients with established
underlying cardiac pathology. It permits higher cumulative doses with a lower
incidence of congestive heart failure and equivalent efficacy to free doxorubicin.
Example:
Doxil: Polyethylene glycol (PEG)-coated liposomal doxorubicin

REFERENCES

Shakir, D. K., &Rasul, K. I. (2009). Chemotherapy Induced Cardiomyopathy: Pathogenesis,

Monitoring and Management. Journal of Clinical Medicine Research.

Saidi, A., &Alharethi, R. (2012). Management of Chemotherapy Induced Cardiomyopathy.

Current Cardiology Reviews, 7(4), 245-249.

Volkova, M., & Russell, R. (2012).AnthracyclineCardiotoxicity: Prevalence, Pathogenesis

and Treatment. Current Cardiology Reviews, 7(4), 214-220.

Alldredge, B. K. (n.d.). Koda-Kimble and young applied therapeutics: the clinical use of
drugs. Philadelphia, PA: Lippincott Williams & Wilkins, 2012.

Australian Medicine Handbook January 2012

Drug information handbook 23RD Edition, 2015