Before Receiving This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For liposomal doxorubicin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to liposomal doxorubicin. Also tell your health care professional if you are allergic to any other substances, such as preservatives.

Pregnancy—This medicine may cause birth defects if either the male or the female parent is receiving it at the time of conception or if it is taken by the mother during pregnancy. In addition, many cancer medicines may cause sterility, which may be permanent. Although sterility has been reported only in male dogs treated with the active ingredient of this medicine, the possibility of an effect in human males should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving liposomal doxorubicin. Tell your doctor right away if you think you have become pregnant while receiving liposomal doxorubicin.

Breast-feeding—Because liposomal doxorubicin may cause serious side effects in a nursing baby, breast-feeding is generally not recommended while you are receiving it.

Children—There is no specific information comparing the use of liposomal doxorubicin in children with use in any other age group. Safety and efficacy of liposomal doxorubicin in children have not been established. However, problems are more likely to occur in children younger than 2 years of age, who are usually more sensitive to the effects of the active ingredient, doxorubicin.

Older adults— This medicine has been tested in a limited number of patients 60 years of age or older and has not been shown to cause different side effects in older people than it does in younger adults. However, problems are more likely to occur in the elderly, who are usually more sensitive to the effects of the active ingredient, doxorubicin. The elderly are also more likely to have blood problems.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking liposomal doxorubicin, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines—Liposomal doxorubicin may increase the effects of these medicines or radiation therapy on the blood

• Daunorubicin (e.g., Cerubidine) or
• Doxorubicin (e.g., Adriamycin) or
• Idarubicin (e.g., Idamycin) or
• Mitoxantrone (e.g., Novantrone)—Concurrent use of maximum cumulative doses of other anthracyclines with liposomal doxorubicin may increase risk of heart damage or blood problems. Concurrent use may increase risk of liver problems.

Other medical problems—The presence of other medical problems may affect the use of liposomal doxorubicin. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Heart disease—Risk of heart problems caused by liposomal doxorubicin may be increased

• Infection—Liposomal doxorubicin can decrease your body's ability to fight infection

• Liver disease—Effects of liposomal doxorubicin may be increased because of slower removal from the body