Daunorubicin (Liposomal)


Cardiotoxicity; Myelosuppression; Infusion Reaction

Cardiotoxicity

  • Cardiac function should be monitored regularly in patients receiving liposomal daunorubicin because of the potential risk for cardiac toxicity and CHF.
  • Cardiac monitoring is advised, especially in those patients who have received prior anthracyclines or who have pre-existing cardiac disease or who have had prior radiotherapy encompassing the heart.
  • Dosage should be reduced in patients with impaired hepatic function.

Myelosupprression

  • Severe myelosuppression may occur

Prescribing

  • This agent should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapy.

Infusion Reaction

  • A triad of back pain, flushing, and chest tightness has been reported in 13.8% of the patients (16/116) treated with this agent in phase III trials, and in 2.7% of treatment cycles (27/994). This triad generally occurs during the first five minutes of the infusion, subsides with interruption of the infusion, and generally does not recur if the infusion is then resumed at a slower rate.

Monitoring data

  • Careful hematological monitoring
  • Evaluate Cardiac function at baseline, before each course, at 320 mg/m2 cumulative dose and every 160 mg/m2 dose thereafter. Risk of cardiac toxicity increased with prior anthracycline use, pre-existing cardiac disease, or radiotherapy encompassing heart.
  • Infusion reaction usually occurs within first 5 minutes of infusion and subsides with infusion interruption. Does not usually recur if infusion restarted at slower rate. Appears to be related to lipid component.