Liposomal Doxorubicin (Caelyx, Myocet, Doxil)

Liposomal doxorubicin is the chemical name for the drug. It is also called by the brand names Caelyx, Myocet or Doxil. Doctors use it to treat some types of cancers, including breast cancer, ovarian cancer, multiple myeloma and a type of sarcoma called Kaposi’s sarcoma.

This drug contains the chemotherapy drug doxorubicin (Adriamycin) wrapped up in a fatty covering called a liposome. This allows the doxorubicin to stay in the bloodstream longer, so that more of the drug reaches the cancer cells. It has fewer side effects on healthy cells than regular doxorubicin, because the fatty covering acts as a barrier.

Liposomal doxorubicin is a light red liquid that you have through a drip (infusion) into a vein. You may have a fine tube (cannula) put into a vein each time you have treatment. Or you may have a semi permanent tube called a central line put into a vein near your collarbone at the beginning of your treatment course.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for liposomal doxorubicin depends on which type of cancer you have. There is detailed information about how doctors plan chemotherapy in this section of CancerHelp UK.

The side effects that liposomal doxorubicin may cause are listed below. Use the links to find out more about each side effect or go to the cancer drug side effects section.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• 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, sore throat, pain passing urine or feel cold and shivery
• 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, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• 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
• Sore mouth or mouth ulcers in up to 1 in 3 people
• Some people develop soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome) which may cause tingling, numbness, pain and dryness
• Red or orange urine within 1 or 2 days of treatment – this is the colour of the drug and is nothing to worry about
• Liposomal doxorubicin may have a harmful effect on a developing baby so talk to your doctor about contraception before having treatment if there is any chance that you or your partner could become pregnant

Between 1 and 10 in every 100 people have one or more of these.

• Diarrhoea – drink plenty of fluids and tell your doctor if it becomes severe or lasts for more than a couple of days as you could get dehydrated
• Constipation can occur in some people – if you get constipated, try to drink plenty of liquids, eat fruit and vegetables and ask your doctor for a laxative
• Sensitivity to the sun during treatment and for several months afterwards – cover up and stay in the shade during this time but if you must go in the sun, use a high factor sun cream (SPF 30 or higher)
• Temporary hair loss or hair thinning may begin 2 to 5 weeks after treatment starts
• An allergic reaction occurs in up to 1 in 10 people (10%) while they are having the drug, causing flushing, breathlessness, swelling of the face, chills, back pain, a headache, or chest tightness – tell your nurse immediately if you have any of these
• An itchy skin rash over most of your body

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 chemotherapy nurse immediately
• Black or brown discoloration in skin creases is particularly likely in children (although this drug is not often given to children)
• Reddening of the skin in areas where you have had radiotherapy in the past, and 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
• 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 and in many people the changes go back to normal after treatment finishes
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if having a baby is important to you
• Changes in your liver that are mild and unlikely to cause any symptoms – the changes usually go back to normal once the treatment ends

The side effects above 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)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your clinic or ward nurse will give you a contact phone number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.