Liposomal doxorubicin is a chemotherapy drug that is also called by the brand names Caelyx or Myocet. It 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
How it works
Doxorubicin is a type of chemotherapy drug called an anthracycline. It works by blocking an enzyme called topo isomerase 2 that cancer cells need in order to divide and grow.
Liposomal doxorubicin is doxorubicin 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.
How you have it
Liposomal doxorubicin is a light red liquid that you have through a drip (infusion) into your bloodstream. It usually takes between 30 to 90 minutes each time you have it.
Into your bloodstream
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
When you have it
You usually have liposomal doxorubicin every 2 to 4 weeks. Your treatment plan will depend on the type of cancer you have.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
Common side effects
Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them. They include:
Increased risk of getting an infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising, bleeding gums and nosebleeds
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. 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 petechia).
Tiredness and weakness (fatigue) during and after treatment
Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all help.
Mouth sores and ulcers
Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.
You might have a sore throat or pain on swallowing.
Soreness, redness and peeling of your hands and feet
The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Red or orange urine
This won't harm you. It’s due to the colour of the chemotherapy and lasts for one or two days.
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will grow back once treatment has finished. But it is likely to be softer. And it may grow back a different colour or be curlier than before.
Diarrhoea or constipation
Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help.
A sudden feeling of cold with shivering often with a rise in temperature and sweating.
Occasional side effects
Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them. They include:
- dehydration - that is not enough water in your body be sure to drink plenty of fluids
- a change to the amount of substances in the blood such as potassium, magnesium, calcium and sodium
- chest pain
- inflammation of the food pipe
- back pain, muscle pain and tummy (abdominal) pain
- shortness of breath
- eye problems such as watery eyes and blurred vision
- sore, red and itchy eyes (conjuntivitis)
- changes to the way your heart works
- numbness or tingling in the fingers and toes
- skin sensitivity to the sun
- an allergic reaction
- thrush in the mouth
- cold sores
- nail changes
- change to the way your liver works
- sore and inflamed tongue
- skin changes such as dry skin, rash or itchimess
- taste changes
- pain when passing urine
Rare side effects
Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them. They include:
- inflammation around the drip site
- pain at the drip site
- skin colour changes - your skin could go red or there might be discolouration or browning in skin folds
- feeling restless
- changes to the way you walk
- difficulty speaking
- low blood pressure
- lung changes
- blood in the spit (sputum)
- stomach ulcer
- blood in the urine
- passing less urine
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else I need to know
Other medicines, food and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Loss of fertility
You may not be able to become pregnant or father a child after treatment with this drug. 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. Women may be able to store eggs or ovarian tissue but this is rare.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
- be in contact with other people who've had live vaccines as injections
Avoid close contact with people who’ve recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.
This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.