Daunorubicin Liposomal Brand Name– DaunoXome
What is Daunorubicin Liposomal
DaunoXome incorporates daunorubicin, an anthracycline chemotherapy agent, into a liposomal carrier. It has been developed to decrease the incidence of severe toxicity seen with the conventional formulation of daunorubicin while taking advantage of the unique delivery properties of liposomes and the cytotoxic effects of daunorubicin.
DaunoXome(R) contains an aqueous solution of the citrate salt of daunorubicin encapsulated within liposomes composed of a lipid bilayer of distearoylphosphatidylcholine and cholesterol (in a 2:1 molar ratio).
As single agent, first-line therapy for advanced Kaposi’s sarcoma, liposomal daunorubicin has a response rate of 23% which is not significantly different from combination chemotherapy consisting of doxorubicin, bleomycin and vincristine.
In April 1996, the FDA approved DaunoXome(R) as the first-line treatment for advanced HIV-associated Kaposi’s sarcoma.
Liposomal daunorubicin is undergoing phase II trials in relapsed and refractory non-Hodgkin’s lymphoma (NHL), as a substitute for doxorubicin in traditional first-line combination NHL regimens such as CHOP, and in breast cancer in combination with taxanes and as a substitute for doxorubicin in combination regimens such as CAF. Other trials are being conducted in prostate cancer, leukemia, soft tissue sarcoma, multiple myeloma and ovarian cancer
Indications
- acute myelogenous leukemia (AML)
- breast cancer
- Kaposi’s sarcoma
- multiple myeloma
- non-Hodgkin’s lymphoma (NHL)
For the treatment of advanced HIV-related Kaposi’s sarcoma
NOTE: Daunorubicin liposomal has been designated an orphan drug by the FDA for this indication.
Side Effects
- abdominal pain
- abdominal pain
- alopecia
- amnesia
- anemia
- angina
- anorexia
- anorexia
- anxiety
- appetite stimulation
- arthralgia
- ataxia
- atrial fibrillation
- back pain
- back pain
- cardiac arrest
- cardiomyopathy
- chest pain (unspecified)
- chest pain (unspecified)
- chills
- confusion
- conjunctivitis
- constipation
- cough
- cough
- dehydration
- depression
- depression
- diarrhea
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dysphagia
- dyspnea
- dyspnea
- dysuria
- edema
- edema
- emotional lability
- fatigue
- fatigue
- fever
- fever
- flushing
- flushing
- gastritis
- GI bleeding
- hallucinations
- headache
- headache
- hearing loss
- heart failure
- hemoptysis
- hemorrhoids
- hepatomegaly
- hiccups
- hot flashes
- hyperhidrosis
- hyperhidrosis
- hypertension
- hypertonia
- infection
- injection site reaction
- injection site reaction
- insomnia
- lymphadenopathy
- malaise
- malaise
- melena
- meningitis
- myalgia
- myocardial infarction
- nausea
- nausea
- neutropenia
- nocturia
- ocular pain
- palpitations
- pericardial effusion
- peripheral neuropathy
- peripheral neuropathy
- polyuria
- pruritus
- pulmonary hypertension
- seizures
- sinus tachycardia
- sinusitis
- splenomegaly
- stomatitis
- stomatitis
- supraventricular tachycardia (SVT)
- syncope
- tenesmus
- tenesmus
- thrombocytopenia
- tinnitus
- tremor
- vomiting
- vomiting
- xerostomia
Monitoring Parameters
- CBC with differential
- echocardiogram
- LFTs
- multi-gated radionuclide angiography (MUGA)
- serum bilirubin
- serum creatinine
Contraindications
- accidental exposure
- angina
- anthracycline hypersensitivity
- bone marrow suppression
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cardiotoxicity
- children
- dental disease
- dental work
- extravasation
- geriatric
- heart failure
- hepatic disease
- herpes infection
- hypertension
- infants
- infection
- infusion-related reactions
- intramuscular administration
- intramuscular injections
- jaundice
- neutropenia
- ocular exposure
- pregnancy
- radiation therapy
- renal impairment
- requires an experienced clinician
- subcutaneous administration
- thrombocytopenia
- vaccination
- varicella
- viral infection
Interactions
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Cyclophosphamide
- Cyclosporine
- Digoxin
- Glecaprevir; Pibrentasvir
- Lumacaftor; Ivacaftor
- Palifermin
- Penicillamine
- Tuberculin Purified Protein Derivative, PPD
