Doxorubicin (HCl)

Doxorubicin should be used with caution in patients who have had previous myelosuppressive therapy such as chemotherapy or radiation therapy, in patients with tumor infiltrate of the bone,with hepatic disease, in patients with dental disease. Dental work should be performed prior to initiating doxorubicin therapy, or deferred until blood counts return to normal. It should be usedwith extreme caution in patients with cardiac disease. Patients with active infection should betreated prior to receiving doxorubicin, the dose should be reduced or discontinued in patients whodevelop such infections. Patients should be observed closely for signs of cardiotoxicity; early recognition is essential for successful treatment of doxorubicin-induced cardiac toxicity. A reduction in dosage and/or dosage interval is indicated in patients with moderate to severe stomatitis. Doxorubicin therapy should not be initiated until patients recover normal hematopoiesis after bone marrow depression. Patients with pre-existing heart failure, with angina, or with cardiac arrhythmias are not good candidates to receive doxorubicin. It should not be administered during pregnancy and lactation.