Xorubin IV Infusion 50mg

✔️ Generic Name:

Doxorubicin Hydrochloride

✔️ Dosage & Administration of Xorubin 50

Single Agent Therapy:

• 60-75 mg/m² IV every 21 days.

Combination Therapy:

• 40-75 mg/m² IV every 21-28 days.

Administration Notes:

• Administer through a central IV line or a free-flowing peripheral venous line over 3-10 minutes.
• Use compatible solutions such as 0.9% Sodium Chloride, 0.45% Sodium Chloride, or 5% Dextrose.
• Decrease infusion rate if erythematous streaking or facial flushing occurs.
• For IV infusion, a central catheter is required.

Management of Extravasation:

• Discontinue infusion immediately upon signs of burning, stinging, or extravasation.
• Do not flush the line or apply pressure.
• Apply ice intermittently for 15 minutes, 4 times daily for 3 days.
• Elevating the affected extremity is involved.
• Consider dexrazoxane administration in adults for extravasation.

Avoid mixing with heparin or fluorouracil (precipitation may occur). Avoid contact with alkaline solutions to prevent hydrolysis. 

• Pediatrics: Risk of long-term cardiovascular dysfunction. Periodic monitoring is recommended.
• Geriatrics: No significant differences in efficacy or safety compared to younger patients.
• Hepatic Impairment: Reduce dosage for bilirubin > 1.2 mg/dL. Contraindicated in severe impairment.

✔️ Uses of Xorubin 50 IV Infusion

Treatment of Breast Cancer

✔️ How does Xorubin 50 IV Infusion work?

Doxorubicin, classified as an anthracycline topoisomerase inhibitor, works by blocking the topoisomerase II enzyme through intercalation with DNA base pairs. This disrupts the uncoiling of the DNA double helix, thereby inhibiting DNA and RNA synthesis.

Xorubin 50 is also utilized in the treatment of a variety of cancers, including acute lymphoblastic leukemia, acute myeloblastic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, metastatic breast cancer, metastatic Wilms’ tumor, metastatic neuroblastoma, metastatic soft tissue sarcoma, metastatic bone sarcomas, metastatic ovarian carcinoma, metastatic transitional cell bladder carcinoma, metastatic thyroid carcinoma, metastatic gastric carcinoma, and metastatic bronchogenic carcinoma.

✔️ Side Effects of Xorubin 50

Common (>10%):

• Alopecia
• Nausea and vomiting

Serious Reactions:

• Cardiac toxicity (e.g., cardiomyopathy, arrhythmias).
• Secondary malignancies.
• Extravasation (leading to tissue necrosis).
• Myelosuppression (severe).
• Tumor lysis syndrome.
• Radiation sensitization and recall.

✔️ Drug Interactions

CYP Enzymes and P-gp: Xorubin is a substrate of CYP3A4, CYP2D6, and P-glycoprotein (P-gp). Avoid concurrent use with inhibitors or inducers of these pathways.

• Inhibitors: Increase the risk of toxicity.
• Inducers: Reduce drug efficacy.

Trastuzumab: Co-administration increases the risk of cardiac dysfunction. Avoid concurrent use.

Paclitaxel: Administer Xorubin before Paclitaxel to avoid increased plasma concentrations of Xorubin and its metabolites.

✔️ Contraindications

• Severe myocardial insufficiency.
• Recent myocardial infarction (within 4-6 weeks).
• Severe drug-induced myelosuppression.
• Severe hepatic impairment (e.g., Child-Pugh Class C, bilirubin > 5 mg/dL).
• Hypersensitivity to Doxorubicin or its components, including anaphylaxis.

✔️ Overdose Effects of Xorubin 50

• Acute myocardial degeneration within 24 hours.
• Severe myelosuppression (peaks 10-15 days post-overdose).
• Delayed cardiac failure (up to 6 months later).

Management: Symptomatic and supportive care.

✔️ Use in Pregnancy & Lactation

• Pregnancy Category D: May cause fetal harm. Women of reproductive potential must use effective contraception during treatment and for 6 months post-treatment.
• Lactation: Excreted in breast milk; breastfeeding should be discontinued due to potential adverse effects on the infant.

✔️ Precautions & Warnings

• Reconstitute with 0.9% Sodium Chloride or 5% Dextrose.
• Protect from light until infusion completion.
• Use impervious gloves during preparation and administration.
• In case of skin or mucosal contact, wash thoroughly with soap, water, or sodium bicarbonate solution.

✔️ Storage:

Store at 2°-8°C in a dry place. Do not freeze. Keep out of reach of children.