Your child needs to take the medicine called daunorubicin (say: daw-no-ROO-bi-sin) or doxorubicin (say: doks-oh-ROO-bi-sin). This information sheet explains what daunorubicin and doxorubicin do, how to give them, and what side effects, or problems your child may have when they take this medicine.
What are daunorubicin and doxorubicin?
Daunorubicin and doxorubicin are medicines which are used to kill cancer cells. You may hear daunorubicin called daunomycin or "dauno" or by its brand name, Cerubidine. Daunorubicin comes in an injection form. You may hear doxorubicin called "doxo" or by its brand name, Adriamycin. Doxorubicin also comes in an injection form.
Before giving daunorubicin and doxorubicin to your child
Tell your doctor if your child:
- has ever reacted badly to daunorubicin, doxorubicin, or any other cancer medication
- has had previous treatment with these or other cancer drugs
Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- a history of heart problems
- an infection or recent exposure to infection (for example chickenpox)
- any problems with their liver
- low blood counts
How should you give your child daunorubicin and doxorubicin?
Daunorubicin and doxorubicin are red liquids given by needle into your child's vein (intravenously or IV). Your child will be given this medicine by a nurse in the hospital clinic or on the nursing unit.
What are the possible side effects of daunorubicin and doxorubicin?
Your child may have some of these side effects while they take daunorubicin/doxorubicin. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:
- nausea (upset stomach) or vomiting (throwing up)
- sores or redness in the mouth, tongue, or lips
- hair loss
- red- or pink-coloured urine (common for 1 to 2 days after a dose)
- skin darkening of the palms, soles, or nails
Call your child's doctor during office hours if your child has any of these side effects:
- skin changes, especially if your child also received radiation
- joint pain
- changes in eyesight
- skin rash or itching
- numbness or tingling in feet or hands
- lower back or side pain
- unusual tiredness or weakness
- loose stools
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- fever or chills
- cough or sore throat
- pain or burning with urination
- large amounts of loose, watery stools (diarrhea)
- unusual bruising or bleeding
- black, tarry stools
- blood in the urine
- fast or irregular heartbeat or pain in the chest
- shortness of breath or trouble breathing
- swelling of the legs or feet
What safety measures should you take when your child is using daunorubicin and doxorubicin?
If daunorubicin/doxorubicin leaks out of the vein through which it is being given, it can cause severe damage. Tell the nurse right away if you notice redness, pain, or swelling at the place of injection.
Daunorubicin and doxorubicin can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child shouldn't touch your child's eyes or inside their nose without washing hands first.
- Your child's nurse and doctor will review with you what to do when you/your child has a fever.
Daunorubicin and doxorubicin can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using a razor, fingernail scissors, or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Your child should not receive a permanent tattoo or any kind of body piercing.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that they are taking daunorubicin/doxorubicin.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) and chickenpox vaccine.
Daunorubicin and doxorubicin may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can tell you how to make this. Do not use store-bought mouthwash that contains alcohol, as it may sting and cause a dry mouth.
Your child may lose their hair. It will grow back once treatment with daunorubicin/doxorubicin stops. The colour and/or texture of the hair may change when it grows back. Use a gentle shampoo and a soft brush on your child's hair.
Daunorubicin and doxorubicin may cause heart damage. Your child will have heart function tests done as needed while receiving daunorubicin/doxorubicin. Contact your child's doctor immediately if your child has a fast or irregular heartbeat, shortness of breath, trouble breathing, or swelling of feet and lower legs.
While your child is taking daunorubicin/doxorubicin, and for several months afterwards, they will be more sensitive to the sun. The skin will burn more easily than normal. To prevent sunburn, your child should wear sunscreen and protective clothing when outdoors.
There is a chance that daunorubicin/doxorubicin may cause birth defects if is taken at the time of conception or it is taken during pregnancy. If your child is sexually active it is best to use some kind of birth control while receiving daunorubicin/doxorubicin. Tell your doctor right away if your child may be pregnant.
After receiving daunorubicin/doxorubicin, your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with your child.
After your child stops receiving daunorubicin/doxorubicin it may still cause side effects. These delayed effects may include certain types of cancer. Check with your doctor right away if any of the following signs occur even after daunorubicin/doxorubicin treatment has stopped:
- yellow eyes or skin
- black tarry stools
- blood in urine or stools
- lower back or side pain
- stomach pain
- cough or a hoarse voice
- unusual bleeding, bruising
- diarrhea
Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
What other important information should you know about daunorubicin and doxorubicin?
- Your child will receive medicine to prevent upset stomach and throwing up caused by daunorubicin/doxorubicin.
- Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep daunorubicin and doxorubicin out of your child’s sight and reach and locked up in a safe place. If your child takes too much daunorubicin and doxorubicin, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.