Doxorubicin drug interactions

The possible impact of co-administered chemotherapies and radiation therapy on the PK of cetuximab was furthermore assessed using the population PK approach, as described in Section 14.6. The co-administered chemotherapies included cisplatin, carboplatin, paclitaxel, doxorubicin, irinotecan, and gemcitabine. The results of the analysis indicate that neither the co-administered chemotherapies nor radiation therapy had a significant impact on the PK of cetuximab. This finding suggests that the potential for PK-based drug-drug interactions with cetuximab is low. 

CICLOSPORIN DOXORUBICIN High doses of cidosporin T AUC of doxorubicin by 48% and of a metabolite by 443%. Risk of severe myelosuppression and neurotoxicity Cidosporin inhibits P-gp and cytochrome P450, which results in 1 clearance of doxorubicin Advise patients to report symptoms such as sore throat, fever, bleeding and bruising - For signs and symptoms of immunosuppression, see Clinical Features of Some Adverse Drug Interactions, Immunosuppression and blood dyscrasias... 

No formal drug interaction studies have been conducted with pegylated liposomal doxorubicin, liposomal daunorubicin, or Myocet. Caution should be exercised when using drugs known to interact with doxorubicin or daunorubicin. Equally, caution should be exercised when giving any other cytotoxic drugs, especially myelotoxic agents, at the same time. 

Schedules for optimal use alone or in combination with other drugs, including doxorubicin and cisplatin, still are evolving. Drug interactions have been noted the sequence of cisplatin preceding paclitaxel decreases paclitaxel clearance and produces greater toxicity than the opposite schedule. Paclitaxel decreases doxorubicin clearance and enhances cardiotoxicity, whereas docetaxel has no apparent effect on anthracycline pharmacokinetics. 

Shuhendler AJ, O Brien P, Rauth AM, Wu XY. On the synergistic effect of doxorubicin and mitomycin C against breast cancer cells. Drug Metabol Drug Interactions 2008 22 201-233. 

To assess the mechanism by which Pluronic copolymers hypersensitise drug resistant tumour cells, we have analysed the effect of these compounds on the drug transport into and within the cells, as well as the drug interaction with DNA, which is known to be the target for cytotoxic activity of doxorubicin. ... 

Drugs that may interact with stavudine include didanosine, doxorubicin, hydroxyurea, methadone, ribavirin, and zidovudine. 

In addition to the hydrophobic interaction mentioned above to encapsulate guest molecules, other types of nonspecific interactions have also been explored to enhance binding. For example, block copolymer micelles based on PEO as hydrophilic segments and poly(/3-benzyl L-aspartate) as hydrophobic blocks have used to encapsulate doxombicin. The encapsulation efficiency of doxombicin, an aromatic anticancer drug molecule, has been found to be significantly higher. This observation has been attributed to the tt-tt interaction between the anthracycUne moiety of doxorubicin and the benzyl group of poly(/3-benzyl L-aspartate) (Cammas-Marion et al. 1999). 

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