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Care During Chemotherapy and Beyond

Daunorubicin Liposomal

(daw-noe-ROO-bi-sin lye-poe-SOE-mal)

Drug type: Daunorubicin (liposomal) is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "anthracycline." (For more detail, see "How Daunorubicin Works" below)

What Daunorubicin (liposomal) Is Used For:

  • Daunorubicin (liposomal) is used as first-line therapy against advanced Kaposi's sarcoma associated with HIV.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Daunorubicin (liposomal) Is Given:

  • Daunorubicin (liposomal) is given into a vein as an infusion over 1 hour.
  • Because the parent drug daunorubicin is a vesicant this liposomal form is treated with equal caution. A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. The nurse or doctor who give this drug must be carefully trained. If you notice redness or swelling at the IV site while you are receiving daunorubicin (liposomal), alert your health care professional immediately.
  • There is no pill form of daunorubicin (liposomal).
  • The amount of daunorubicin (liposomal) you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dose and schedule.

Side Effects

Important things to remember about the side effects of daunorubicin (liposomal):

  • Most people will not experience all of the daunorubicin (liposomal) side effects listed.
  • Daunorubicin (liposomal) side effects are often predictable in terms of their onset, duration, and severity.
  • Daunorubicin (liposomal) side effects will improve after therapy is complete.
  • Daunorubicin (liposomal) side effects may be quite manageable. There are many options to minimize or prevent the side effects of daunorubicin (liposomal).

The following side effects are common (occurring in greater than 30%) for patients taking daunorubicin (lipsomal):

These are less common side effects (occurring in in 10-29%) for patients taking daunorubicin (liposomal):

A serious but uncommon side effect of daunorubicin (liposomal) can be interference with the pumping action of the heart. The chance of heart problems may be raised if you are using other drugs that may cause heart problems or if you have ever had heart problems or radiation to the chest area, or if you have ever had this drug or other anthracyclines similar to this drug before. Your chance of heart problems depends on your dose of this drug and your health condition. Your doctor will check your heart function before you may take any daunorubicin (liposomal) and will monitor your heart closely during your treatment. Dose-related heart problems can occur as late as 7 or 8 years after treatments have ended.

Another serious side effect of daunorubicin (liposomal) is that it may lower your body's ability to make blood cells that your body needs. This can lead to the need for a blood transfusion, which can further cause bleeding complications and infections. Your doctor will check to make sure your body is making the blood cells it needs, but be sure to tell your doctor right away if you have any signs of infection or bleeding, such as: fever, chills, sore throat, bruising, abnormal bleeding, and feeling weak or tired.

Some individuals will experience certain side effects during the infusion such as back pain, flushing, and tightness of their chest and throat. The chance of having an infusion reaction is very low and generally only happens during the first 5 minutes of the first infusion. Tell your doctor right away if you experience any of these side effects during the infusion. The side effects go away upon stopping the infusion and typically do not reoccur when the infusion is restarted at a slower rate.

If you have liver disease or any type of liver dysfunction, tell your doctor, to ensure the correct dose of daunorubicin (liposomal) is chosen for you.

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
  • Blistering of the IV site
  • Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling or facial features, hives (possible allergic reaction)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers)
  • Fast or irregular heart beats
  • Swelling of the feet or ankles
  • Yellowing of the eyes or skin

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting daunorubicin (liposomal) treatment, make sure you tell your doctor about any other medications you are taking (including prescriptions, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • People with congestive heart failure, those who have already had high doses of this drug or a similar drug, and those with permanent problems with blood counts (bone marrow suppression) cannot receive this drug.
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  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking daunorubicin (liposomal)
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (daunorubicin (liposomal) may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking daunorubicin (liposomal). Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.
  • You may be more sensitive to sunlight, take extra care to avoid sun exposure.

Self-Care Tips

  • Apply ice if you have any pain, redness or swelling at the IV site, and notify your doctor.
  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Use care to keep body fluids from coming in contact with your family members or caregivers.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Daunorubicin (liposomal)

A baseline heart evaluation is recommended before starting treatment, and a heart function test will be done as your doctor prescribes. You will be checked regularly by your doctor while you are taking daunorubicin (liposomal), to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Daunorubicin (liposomal) Works

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the genetic material, RNA or DNA, which tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, and/or hair loss.

Daunorubicin is classified as an anthracycline. Anthracyclines interact with your genetic material causing cell death of both your cancerous and noncancerous cells. Daunorubicin (liposomal) is the drug daunorubicin encapsulated in a liposome. By enclosing a drug in a liposome (lipid sphere or coating), scientists have demonstrated improvements in the way a drug is released throughout the body and the amount of time it remains within the body. Liposomes may circulate in the bloodstream for extended periods allowing for an extended treatment effect. In some cases, liposomal drugs have been shown to accumulate at the site of a tumor delivering high concentrations of the drug to the disease target. The liposome carrier is believed to play a role in reducing the harmful effects of certain drugs on healthy tissues.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Reference: Daunorubicin (liposomal). Lexicomp Online® [17 April 2017]. Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc.; 17 April 2017.

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