Main content

    Health Information

    Doxorubicin

    Doxorubicin



    Drug Information

    Doxorubicin is a chemotherapy drug used primarily to treat people with cancer.

    Common brand names:

    Adriamycin PFS, Adriamycin RDF

    Summary of Interactions with Vitamins, Herbs, & Foods

    Reference What Are Nutrient Interactions
    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • Reference Vitamin B2
      Animal studies suggest that doxorubicin interferes with the body's utilization of riboflavin (vitamin B2). In rats, supplementation with riboflavin prevented the development of cardiac abnormalities resulting from treatment with doxorubicin1.
      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Reduce Side Effects

    • Reference Coenzyme Q10

      Pretreating people with the Reference antioxidant coenzyme Q10 before administration of doxorubicin has reduced cardiac toxicity2 —an action also reported in animals.3 Some doctors recommend 100 mg per day.

    • Reference Vitamin B2

      Animal research suggests doxorubicin may deplete riboflavin and that riboflavin deficiency promotes doxorubicin toxicity.4

    • Reference L-Carnitine

      Animal research suggests carnitine may prevent doxorubicin’s toxicity.5

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Reference Vitamin C

      The antioxidant vitamin C has protected against cardiotoxicity (damage to the heart) of doxorubicin in an animal study.6 In this trial, vitamin C significantly increased the life expectancy of mice and guinea pigs without interfering with anticancer action of the drug. Despite the lack of human data, some doctors recommend that patients taking doxorubicin supplement at least 1 gram of vitamin C per day.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Reference Vitamin E

      Animal studies show that the Reference antioxidant activity of vitamin E protects against doxorubicin-induced cardiotoxicity.7 , 8 Test tube evidence suggests that vitamin E might also enhance the anticancer action of the drug.9 Human trials exploring the cardioprotective action of vitamin E in people taking doxorubicin remain inconclusive; however, some evidence suggests that vitamin E may allow for higher drug doses without increasing toxicity.10

      Anecdotal reports indicate that very high (1,600 IU) amounts of vitamin E may reduce the amount of hair loss accompanying use of doxorubicin.11 However, while protection against hair loss was confirmed in a rabbit study, human research has not found this to be true.12

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Support Medicine

    • none

    Reduces Effectiveness

    • none

    Potential Negative Interaction

    • none

    Explanation Required 

    • Reference Melatonin

      Melatonin supplementation (20 mg per day) has decreased toxicity and improved effectiveness of chemotherapy with doxorubicin.13

    • Reference N-Acetyl Cysteine

      The antioxidant supplement N-acetyl cysteine (NAC) has protected animals from the cardiotoxicity of doxorubicin,14 although human research has not been able to confirm these results.15 Most doctors do not yet suggest NAC for people taking doxorubicin.

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

    References

    1. Pinto J, Raiczyk GB, Huang YP, Rivlin RS. New approaches to the possible prevention of side effects of chemotherapy by nutrition. Cancer 1986;58:1911-14.

    2. Judy WV, Hall JH, Dugan W, et al. Coenzyme Q10 reduction of Adriamycin® cardiotoxicity. In Biomedical and Clinical Aspects of Coenzyme Q, vol. 4, ed. K Folkers, Y Yamamura. Amsterdam: Elsevier/North Holland Biomedical Press, 1984, 231–41.

    3. Ogura R, Toyama H, Shimada T, Murakami M. The role of ubiquinone (coenzyme Q10) in preventing Adriamycin®-induced mitochondrial disorders in rat heart. J Appl Biochem 1979;1:325.

    4. Pinto J, Raiczyk GB, Huang YP, Rivlin RS. New approaches to the possible prevention of side effects of chemotherapy by nutrition. Cancer 1986;58:1911–4.

    5. Alberts DS, Peng Y-M, Moon TE, Bressler R. Carnitine prevention of adriamycin toxicity in mice. Biomedicine 1978;29:265–8.

    6. Fujita K, Shinpo K, Yamada K, et al. Reduction of Adriamycin® toxicity by ascorbate in mice and guinea pigs. Cancer Res 1982;42:309–16.

    7. Myers C, McQuire W, Young R. Adriamycin® amelioration of toxicity by alpha-tocopherol. Cancer Treat Rep 1976;60:961–2.

    8. Sonneveld P. Effect of alpha-tocopherol on the cardiotoxicity of Adriamycin® in the rat. Cancer 1978;62:1033–6.

    9. Ripoll EAP, Rama BN, Webber MM. Vitamin E enhances the chemotherapeutic effects of Adriamycin® on human prostatic carcinoma cells in vitro. J Urol 1986;136:529–31.

    10. Weijl NI, Cleton FJ, Osanto S. Free radicals and antioxidants in chemotherapy-induced toxicity. Cancer Treatment Rev 1997;23:209–40 [review].

    11. Wood LA. Possible prevention of Adriamycin®-induced allopecia by tocopherol. N Engl J Med 1985;312:1060 [letter].

    12. Weijl NI, Cleton FJ, Osanto S. Free radicals and antioxidants in chemotherapy-induced toxicity. Cancer Treatment Rev 1997;23:209–40 [review].

    13. Lissoni P, Barni S, Mandala M, et al. Decreased toxicity and increased efficacy of cancer chemotherapy using the pineal hormone melatonin in metastatic solid tumour patients with poor clinical status. Eur J Cancer 1999;35:1688–92.

    14. Doroshow JH, Locker GY, Ifrim I, et al. Prevention of doxorubicin cardiac toxicity in the mouse by N-acetylcysteine. J Clin Invest 1981;68:1053–64.

    15. Meyers C, Bonow R, Palmeri S, et al. A randomized controlled trial assessing the prevention of doxorubicin cardiomyopathy by N-acetylcysteine. Semin Oncol 1983;10:53–5.

    Last Review: 11-07-2012

    LogoCpyrt.gif

    Copyright © 2012 Aisle7. All rights reserved. Aisle7.com

    Please read the Reference disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.

    Reference Learn more about Aisle7, the company.

    The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2013.



    This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.


    Topic Contents