Doxorubicin (hydroxydaunorubicin)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`DRUG-DOXORUBICIN`
Type	Drug
Aliases	AdriamycinDoxil (liposomal — different drug entity)DoxorubicinHydroxydaunorubicinДоксорубіцин
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-AITL` `DIS-ALCL` `DIS-ATLL` `DIS-B-ALL` `DIS-BREAST` `DIS-BURKITT` `DIS-CHL` `DIS-CHONDROSARCOMA` `DIS-DLBCL-NOS` `DIS-EATL` `DIS-FL` `DIS-HGBL-DH` `DIS-HSTCL` `DIS-MCL` `DIS-MPNST` `DIS-NLPBL` `DIS-PMBCL` `DIS-PTCL-NOS` `DIS-PTLD` `DIS-SOFT-TISSUE-SARCOMA` `DIS-T-ALL`
Sources	`SRC-NCCN-BCELL-2025`

Drug Facts

Class	antineoplastic — anthracycline topoisomerase II inhibitor
Mechanism	Intercalates DNA, inhibits topoisomerase II → DNA double-strand breaks. Generates free radicals (mechanism of cardiotoxicity). Cell-cycle non-specific.
Typical dosing	50 mg/m² IV day 1 of 21-day cycle (R-CHOP); cumulative dose limit ~450-500 mg/m² lifetime (cardiotoxicity)
Ukraine registered	True
NSZU reimbursed	True
Ukraine last verified	2026-04-27

Warnings

Cardiomyopathy / heart failure (cumulative-dose-dependent)
Severe myelosuppression
Extravasation = severe tissue necrosis (give via central line preferred)
Secondary leukemia

Notes

Baseline echocardiogram (LVEF) mandatory before first dose; surveillance during therapy especially after cumulative dose >300 mg/m². Dexrazoxane cardioprotectant available for high-cumulative-dose scenarios. Liposomal doxorubicin (Doxil) has different toxicity profile — separate drug entity.

Used By

Contraindications

CI-LVEF-LOW-FOR-ANTHRACYCLINE - CI-LVEF-LOW-FOR-ANTHRACYCLINE

Regimens

REG-A-AVD - A+AVD (Brentuximab vedotin + Adriamycin + Vinblastine + Dacarbazine), 6 cycles
REG-ABVD - ABVD (Adriamycin + Bleomycin + Vinblastine + Dacarbazine), 2-6 cycles
REG-AV-HEPATIC-MODIFIED - AV (Doxorubicin + Vinblastine, ABVD-modified for HL with severe hepatic impairment Child-...
REG-CHOEP - CHOEP (cyclophosphamide + doxorubicin + vincristine + etoposide + prednisone), 6 cycles
REG-CHOEP-ALLOSCT-CONSOLIDATION - CHOEP × 6 + allogeneic SCT consolidation in CR1 (fit transplant-eligible PTCL NOS)
REG-CHP-BV - Brentuximab vedotin + CHP (CHP-Bv), 6 cycles (CD30+ T-cell lymphomas)
REG-CODOX-M-IVAC - CODOX-M / IVAC alternating × 4 (Magrath protocol)
REG-DA-EPOCH-R - Dose-Adjusted EPOCH + Rituximab (DA-EPOCH-R), 6 cycles
REG-DOXORUBICIN-CHONDROSARCOMA - Doxorubicin monotherapy (advanced chondrosarcoma, 1L palliative)
REG-DOXORUBICIN-IFOSFAMIDE-MPNST - Doxorubicin + ifosfamide (advanced/metastatic MPNST, 1L)
REG-DOXORUBICIN-IFOSFAMIDE-STS - Doxorubicin + ifosfamide (soft tissue sarcoma, AI regimen)
REG-DOXORUBICIN-STS - Doxorubicin monotherapy (soft tissue sarcoma)
REG-HYPER-CVAD-R - Hyper-CVAD + Rituximab (CD20+) — alternating courses A/B, 8 cycles total
REG-MCL-INTENSIVE-RDHAP-AUTOSCT - Intensive 1L MCL: alternating R-CHOP / R-DHAP × 6 cycles + autoSCT consolidation + R main...
REG-NIVO-AVD - N+AVD (Nivolumab + Adriamycin + Vinblastine + Dacarbazine), 6 cycles — emerging 1L standa...
REG-PEMBRO-CHEMO-TNBC-NEOADJUVANT - Pembrolizumab + chemo (TNBC neoadjuvant)
REG-POLA-R-CHP - Polatuzumab vedotin + Rituximab + CHP (Pola-R-CHP), 6 cycles + 2× rituximab
REG-R-CHOP - Rituximab + CHOP (R-CHOP), 6 cycles