Liposomal doxuribicin : MYOCET
So many people have been so kind and left
wonderful messages. I am going through the side
effects at the moment but promise I will answer
every single one.
I need a few days to get through this.
Meanwhile, this is the treatment I am on…this in
my case is for advanced Breast Cancer.
up by Macmillan:
Liposomal doxorubicin (Caelyx®, Myocet®)
Liposomal doxorubicin is a chemotherapy| drug
that is given as a treatment for some types of
cancer . It is most commonly used to treat
ovarian cancer| and Aids-related Kaposi’s
sarcoma| , but may also be used to treat
advanced breast cancer| .
Pis a chemotherapy drug.
In liposomal doxorubicin the molecules of the
drug are enclosed (encapsulated) in a fatty
coating known as liposome. The liposome allows
the doxorubicin to remain in the body for longer
so that a greater amount of chemotherapy is
delivered to the cancer cells, while having
fewer side effects on healthy tissue.
Liposomal doxorubicin isn’t suitable for
everyone who needs doxorubicin and you may find
it helpful to discuss this with your cancer
specialist, who will be able to advise you on
whether this type of treatment is appropriate
There are two liposomal doxorubicin drugs that
work in slightly different ways and are used to
treat different types of cancer. These are
Caelyx® and Myocet®.
Caelyx® is a form of doxorubicin| that is
enclosed in liposomes. It is sometimes known as
pegylated doxorubicin hydrochloride (PLDH). It
is used to treat:
* Advanced ovarian cancer
that has come back after being treated with a
platinum-based chemotherapy drug.
* Women with advanced
breast cancer who have an increased risk of
heart damage from other chemotherapy drugs.
* Aids-related Kaposi’s
Myocet® , another form of liposomal doxorubicin,
is used to treat advanced (metastatic) breast
cancer| in combination with another chemotherapy
drug, cyclophosphamide| .
What it looks like
Liposomal doxorubicin is a light red fluid.
How it is given
doxorubicin may be given by a drip (infusion):
through a fine tube (cannula) placed into the
vein, usually in the back of the hand
through a fine plastic
tube that is inserted under the skin into a vein
near the collarbone (central line )
* into a fine tube that
is inserted into a vein in the crook of your arm
(PICC line ).
The Infusion usually takes 60-90 minutes.
Chemotherapy is usually given as a course of
several sessions (cycles) of treatment over a
few months. The length of your treatment and the
number of cycles you have will depend on the
type of cancer for which you are being treated.
Your nurse or doctor will discuss your treatment
plan with you.
Possible side effects
Each person’s reaction to chemotherapy is
different. Some people have very few side
effects; while others may experience more. The
side effects described in this information won’t
affect everyone who is given liposomal
doxorubicin, and may be different if you are
having more than one chemotherapy drug.
We have outlined the most common side effects
and some of the less common ones, so that you
can be aware of them if they occur. However, we
haven’t included those that are very rare and
therefore extremely unlikely to affect you. If
you notice any effects which you think may be
due to the drug, but which aren’t listed in this
information, please discuss them with your
doctor, chemotherapy nurse or pharmacist.
Lowered resistance to infection Liposomal
doxorubicin can reduce the production of white
blood cells by the bone marrow, making you more
prone to infection| . This effect can begin
seven days after treatment has been given, while
your resistance to infection usually reaches its
lowest point 10-14 days after chemotherapy. The
number of your white blood cells will then
increase steadily, and will usually have
returned to normal levels before your next cycle
of chemotherapy is due.
Contact your doctor or the hospital straight
* your temperature goes
above 38ºC (100.4ºF)
* you suddenly feel unwell
(even with a normal temperature).
You will have a blood test before having more
chemotherapy to make sure that your cells have
recovered. Occasionally it may be necessary to
delay your treatment if the number of blood
cells (the blood count) is still low.
Bruising or bleeding Liposomal doxorubicin can
reduce the production of platelets (which help
the blood to clot). Let your doctor know if you
have any unexplained bruising or bleeding, such
as nosebleeds, blood spots or rashes on the
skin, or bleeding gums.
Anaemia (low number of red blood cells) While
having treatment with liposomal doxorubicin you
may become anaemic. This may make you feel
tired| and breathless| . Let your doctor or
nurse know if these symptoms are a problem.
Sore mouth and ulcers Your mouth may become
sore| , or you may notice small ulcers during
this treatment. Drinking plenty of fluids, and
cleaning your teeth regularly and gently with a
soft toothbrush, can help to reduce the risk of
this happening. Tell your nurse or doctor if you
have any of these problems, as special
mouthwashes and medicine to prevent or clear any
mouth infection can be prescribed.
Taste changes You may notice that your food
tastes different. Normal taste usually comes
back after the treatment finishes.
Skin changes Your skin may darken, due to excess
production of pigment. This usually returns to
normal a few months after the treatment has
Areas of skin that have previously been treated
with radiotherapy may become sensitive again
while you are being treated with liposomal
Soreness and redness of the palms of the hands
and soles of the feet If you are being treated
with Caelyx, you may develop red palms and soles
of the feet, sometimes referred to as palmar
plantar, or hand and foot syndrome. This effect
can begin after two or three cycles of
treatment, but is temporary. It will usually
begin to improve within 1-2 weeks after the
treatment is finished. You may be prescribed
vitamin B6 (pyridoxine), which can help to
It can also help to keep your hands and feet
cool and to avoid tight fitting clothing, such
as socks, shoes and gloves. Palmar plantar is
unlikely to happen if you are being treated with
Hot flushes or backache Some people have hot
flushes or backache when the drug is being
Sensitivity to the sun While you are having
liposomal doxorubicin, and for several months
afterwards, you will be more sensitive to the
sun and your skin may burn more easily than
normal. You can still go out in the sun, but
always wear a high protection factor suncream
and protective clothing.
Discoloured urine Your urine may become a
red/orange colour. This may last for a few hours
after having liposomal doxorubicin and is due to
the colour of the drug. It is quite normal.
Fever, chills and allergic reactions Back pain,
breathlessness, headaches and swelling of the
face may occur from the time the drug is given.
If you do develop these symptoms the infusion
may be stopped and re-started at a slower rate.
Your doctor may prescribe a drug that can reduce
these side effects and which can be given before
your next treatments.
Tiredness and feeling weak It is important to
allow yourself plenty of time to rest.
Less common side
Feeling sick (nausea) and being sick (vomiting)
If you do feel sick this may begin a few hours
after the treatment is given and last for up to
a day. Your doctor can prescribe very effective
anti-sickness (anti-emetic) drugs to prevent, or
greatly reduce, nausea and vomiting| .
If the sickness is not controlled, or continues,
tell your doctor; they can prescribe other
anti-sickness drugs which may be more effective.
Some anti-sickness drugs can cause constipation.
Let your doctor or nurse know if this is a
Changes in the way your heart works Liposomal
doxorubicin can affect how the heart works. The
effect on the heart depends on the dose given.
It is very unusual for the heart to be affected
by standard doses of this treatment. If affected
the heart normally goes back to normal once the
chemotherapy is finished. Tests to see how your
heart is working may sometimes be carried out
before the drug is given.
This is more likely to occur if you are being
treated with Myocet than Caelyx, although it can
happen with both. It usually starts 2-4 weeks
after the first dose of liposomal doxorubicin,
although it may occur earlier. Your hair may
just thin but could fall out completely,
although this is rare. You may also have
thinning and loss of eyelashes, eyebrows and
other body hair. Hair loss| is temporary and
your hair will start to regrow once the
Injection site If you notice any stinging or
burning around the vein while the drug is being
given, or any leakage of fluid from the cannula
site it is very important that you tell the
doctor or nurse.
If the area around the injection site becomes
red or swollen you should either tell the doctor
on the ward or, if you are at home you should
ring the clinic or ward and ask to speak to the
doctor or nurse.
Risk of blood clots Cancer can increase your
risk of developing a blood clot (thrombosis),
and having chemotherapy may increase this risk
further. A blood clot may cause symptoms such as
pain, redness and swelling in a leg, or
breathlessness and chest pain. Blood clots can
be very serious so it is important to tell your
doctor straightaway if you have any of these
symptoms. However, most clots can usually be
successfully treated with drugs to thin the
blood. Your doctor or nurse can give you more
Other medicines Some medicines may be harmful to
take when you are having chemotherapy, including
those you can buy in a shop or chemist. Let your
doctor know about any medicines you are taking,
including over-the-counter drugs, complementary
therapies and herbal drugs
Fertility Your ability to become pregnant or
father a child may be affected by taking this
drug. It is important to discuss fertility| with
your doctor before starting treatment.
Contraception It’s not advisable to become
pregnant or father a child while taking
liposomal doxorubicin, as the developing foetus
may be harmed. It is important to use effective
contraception while taking this drug, and for at
least a few months afterwards. Again, discuss
this with your doctor.