Liposomal doxorubicin (Caelyx, Myocet, Doxil)
This page tells you about the chemotherapy drug liposomal doxorubicin and its possible side effects. You can read about
- What liposomal doxorubicin is
- How liposomal doxorubicin works
- How you have liposomal doxorubicin
- Tests during treatment
- About side effects
- Common side effects
Liposomal doxorubicin is the chemical name for a chemotherapy drug that is also called by the brand names Caelyx, Myocet or Doxil. This drug contains the chemotherapy drug doxorubicin (Adriamycin) wrapped up in a fatty covering called a liposome.
It is a treatment for some types of cancer, including
- Breast cancer
- Ovarian cancer
- Multiple myeloma
- A type of sarcoma called Kaposi’s sarcoma
Doxorubicin is a type of chemotherapy drug called an anthracycline. It slows or stops the growth of cancer cells. One way that doxorubicin works is by blocking an enzyme called topo isomerase 2 that cancer cells need in order to divide and grow. The doxorubicin is contained in tiny spheres called pegylated liposomes. These spheres keep the doxorubicin in the bloodstream longer, so that more of the drug reaches the cancer cells.
Liposomal doxorubicin is a light red liquid that you have through a drip (infusion) into your bloodstream. You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
Each treatment usually takes between 30 to 90 minutes. You usually have liposomal doxorubicin every 2 to 4 weeks. Your treatment plan will depend on which type of cancer you have.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.
We've listed the side effects associated with liposomal doxorubicin below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having liposomal doxorubicin with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick, which is usually well controlled with anti sickness medicines but it is important to tell your nurse if you still feel sick
- A sore mouth or mouth ulcers occur in up to 3 in 10 people (30%)
- Sores in the throat can make it painful to swallow – let your doctor or nurse know if you have this
- Soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome). This may cause tingling, numbness, pain and dryness. Let your doctor or nurse know if you have this
- Red or orange urine within 1 or 2 days of treatment – this is the colour of the drug and won't harm you
- Loss of appetite
- Weight loss
- Temporary hair loss or hair thinning may begin 2 to 5 weeks after treatment starts
- Diarrhoea – drink plenty of fluids. Tell your doctor or nurse if it becomes severe or lasts for more than a couple of days
- Constipation can occur in some people – if you get constipated, try to drink plenty of liquids, eat fruit and vegetables and ask your doctor or nurse for a laxative
Between 1 and 10 in every 100 people have one or more of these.
- Watery eyes, sore eyes or blurred vision
- Heart muscle damage, which may change the rhythm of the heartbeat or make your heart work less well. Your doctor or nurse will check your heart before you start treatment. In many people the changes go back to normal after treatment ends
- Numbness or tingling in the fingers and toes happens to nearly everyone and is usually worse if you are cold. You may have trouble with fiddly tasks such as doing up buttons. This can start a few days or weeks after treatment and usually goes away within a few months of the treatment ending
- Sensitivity to the sun during treatment and for several months afterwards – cover up and stay in the shade during this time. If you must go in the sun, use a high factor sun cream (SPF 50 or higher)
- An allergic reaction occurs in up to 1 in 10 people (10%) while they are having the drug. This causes flushing, breathlessness, swelling of the face, chills, back pain, a headache, or chest tightness. Tell your nurse straight away if you have any of these effects
- An itchy, inflamed skin rash over most of your body
- Tummy (abdominal pain)
- Thrush (fungal infection) in the mouth
- Cold sores
- Dizziness – don't drive or operate machinery if you have this
- Bone, muscle or joint pain
- Fluid build up causing swollen legs or hands
- Nail changes
- A sore, inflamed tongue
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Changes in your liver that are mild and unlikely to cause any symptoms. The changes usually go back to normal once the treatment ends
Fewer than 1 in 100 people have these.
- Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
- Black or brown discoloration in skin creases
- Reddening of the skin in areas where you have had radiotherapy in the past. The skin may get dry and flaky and feel sore and hot. This goes away on its own but keep affected areas out of the sun
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug is harmful to babies developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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