Doxorubicin (drug interactions)
Doxorubicin is a chemotherapy drug commonly used to treat various forms of cancer, known under trade names such as Adriamycin, Doxil, and Rubex. Understanding the drug's interactions is crucial for patients to avoid complications during treatment. Antioxidants are a focal point of interest; while they are thought to mitigate some of doxorubicin's side effects by scavenging free radicals, scientific support from human studies remains limited. Substances like vitamin E have shown promise in animal studies for reducing cardiac toxicity, but similar benefits have not been corroborated in humans. Conversely, certain herbs and supplements like St. John's wort and ginseng may lower doxorubicin’s effectiveness, while garlic could heighten the risk of bleeding. Caution is also advised concerning other medications, particularly heart drugs, blood thinners, and live vaccines, which may interact negatively with doxorubicin. Ultimately, patients must consult healthcare professionals to navigate these potential interactions effectively.
On this Page
Subject Terms
Doxorubicin (drug interactions)
RELATED DRUGS: Hydroxydaunomycin, Hydroxydoxorubicin, Liposomal doxorubicin
DEFINITION: A chemotherapy drug used to treat many different forms of cancer.
INTERACTION: Antioxidants, St. John's wort, ginseng, garlic, vitamin E, various prescription medications
TRADE NAMES: Adriamycin, Doxil, Rubex
Antioxidants
Effect: Possible Helpful Interactions
It is hypothesized that many of doxorubicin's side effects occur through the production of free radicals, dangerous substances that can harm many cells. Antioxidants scavenge or quench free radicals. On this basis, several antioxidants have been proposed to reduce doxorubicin toxicity. While some evidence of benefit has been seen in animal studies, there is inadequate supporting evidence from human trials. For example, while vitamin E has shown promise for preventing cardiac toxicity in animal studies, it has persistently failed to prove effective in people.
According to animal studies, lycopene might help protect the heart and also shield developing sperm cells from injury (thereby reducing male infertility); the herbal extract curcumin might help prevent damage to the heart and kidneys; N-acetylcysteine might help protect the heart and also reduce hair loss; lipoic acid and coenzyme Q10 might protect the heart. However, support from human trials is lacking for all of these antioxidants. One animal study hints at the supplement carnitine's potential heart- and liver-protective effects.
Although antioxidants may have positive effects on patients taking doxorubicin, there are several herbs and supplements that may have negative interactions. St. John’s wort and ginseng can decrease the drug’s effectiveness. Garlic can increase the risk of bleeding when taken with doxorubicin. Vitamin E can carry cardiovascular risks. Other chemotherapy drugs, heart medications, blood thinners, and live vaccines should also be avoided when taking doxorubicin.
Bibliography
Balli, E., et al. "Effect of Melatonin on the Cardiotoxicity of Doxorubicin." Histology and Histopathology, vol. 19, 2004, pp. 1101-1108.
Berthiaume, J. M., et al. "Dietary Vitamin E Decreases Doxorubicin-Induced Oxidative Stress Without Preventing Mitochondrial Dysfunction." Cardiovascular Toxicology, vol. 5, 2005, pp. 257-267.
Johnson-Arbor, Kelly. "Doxorubicin - StatPearls." NCBI, 8 Aug. 2023, www.ncbi.nlm.nih.gov/books/NBK459232. Accessed 10 Sept. 2024.
Karimi, G., M. Ramezani, and A. Abdi. "Protective Effects of Lycopene and Tomato Extract Against Doxorubicin-Induced Cardiotoxicity." Phytotherapy Research, vol. 19, 2005, pp. 912-914.
Kim, C., et al. "Modulation by Melatonin of the Cardiotoxic and Antitumor Activities of Adriamycin." Journal of Cardiovascular Pharmacology, vol. 46, 2005, pp. 200-210.
Matyszewska, Dorota, et al. "Interactions of Anticancer Drugs Doxorubicin and Idarubicin with Lipid Monolayers: New Insight into the Composition, Structure and Morphology." Journal of Colloid and Interface Science, vol. 581, pp, 403-16, 1 Jan. 2021, doi.org/10.1016/j.jcis.2020.07.092. Accessed 10 Sept. 2024.
Oz, E., and M. N. Ilhan. "Effects of Melatonin in Reducing the Toxic Effects of Doxorubicin." Molecular and Cellular Biochemistry, vol. 286, 2006, pp. 11-15.
Oz, E., et al. "Prevention of Doxorubicin-Induced Cardiotoxicity by Melatonin." Molecular and Cellular Biochemistry, vol. 282, 2005, pp. 31-37.
Yilmaz, S., et al. "Protective Effect of Lycopene on Adriamycin-Induced Cardiotoxicity and Nephrotoxicity." Toxicology, vol. 218, 2005, pp. 164-171.