Administration of Adriamycin (Doxorubicin)

  1. In dogs, pretreat with diphenhydramine (Benadryl) 1mg/lb IM, or any other H 1- antihistamine. No pretreatment is necessary in cats.
  2. Place an indwelling catheter and make sure it is patent.
  3. Dilute the doxorubicin to approximately 0.5 mg/ml (e.g.; 20 ml of saline per 10 mg of doxorubicin).
  4. Check catheter patency using plain 0.9% NaCl, do not use heparinized NaCl.
  5. Inject the doxorubicin slowly, over 20- 30 minutes.
  6. Aspirate every few ml to make sure catheter is patent. If the patency is questionable, stop administration, remove the catheter, and use a different vein. CALL US IMMEDIATELY IF THIS HAPPENS.
  7. Should perivascular injection occur, remove the catheter and CALL OSU IMMEDIATELY. There are new approaches to prevent necrosis from perivascular doxorubicin, but they have to be implemented within hours of the event. In the meantime, local injection of corticosteroids may be beneficial. Ice packs should be applied on the affected area for 2-3 days.
  8. If hypersensitivity reactions to the drug occur (head shaking, pruritus, urticaria) discontinue the injection and give 0.5 mg/lb of diphenhydrameine (Benadryl) IM or IV. If the reaction continues, give 1-2 mg/lb of dexamethasone IV. When the hypersensitivity reaction subsides, continue injection of doxorubicinIf you have any problems or questions call the Oncology Service at The Ohio State University, College of Veterinary Medicine at 614-292-3551.