Do not give IM or SC due to severe local tissue necrosis. Risk of developing cardiac toxicity in active or dormant CV disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy w/ other anthracyclines or anthracenediones, concomitant use of cardiotoxic drugs, doxorubicin & Ca channel entry blockers, those w/ long t½
(eg, trastuzumab). Probable toxicity of doxorubicin & other anthracyclines or anthracenediones is additive. Cardiomyopathy &/or congestive heart failure may be encountered several months or years after discontinuation of doxorubicin therapy. Secondary acute myelogenous leukemia or myelodysplastic syndrome. Impaired hepatic function. Severe myelosuppression. Acute life-threatening arrhythmias. Phlebosclerosis resulting from an inj into a small vessel or repeated inj into the same vein. Extravasation. Perform a MUGA or an ECHO scan, particularly w/ higher, cumulative anthracycline doses. Total & differential WBC, RBC, & platelet counts should be assessed before & during each cycle of therapy. Hepatic impairment. Pregnancy & lactation. Childn.