Brenda Spriggs, MD, MPH, MBA
Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide) make up the chemotherapy regimen known as AC. These medications are commonly used together for the treatment of breast cancer. According to the National Cancer Institute, Adriamycin is approved for use in combination with Cytoxan and/or other chemotherapy drugs for breast cancer that has spread to the lymph nodes. Cytoxan is used for many types of cancer, and is not usually used alone for chemotherapy treatment.
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Cytoxan is a clear fluid once mixed, and Adriamycin is noted for being bright red. Adriamycin and Cytoxan are both given intravenously; Adriamycin is administered first, followed by Cytoxan. Medications designed to prevent side effects are given before treatment. Administration of the chemotherapy is typically done in about an hour. The University of Virginia states that these medications are typically given four to six times over a period of up to six months. Treatment is usually every two to four weeks. Doses are dependent on the type of cancer, the patient's weight and overall health.
How They Work
Adriamycin is an anti-tumor drug that attacks the part of a cancer cell responsible for synthesizing RNA and DNA, according to Chemocare.com. Cytoxan is an alkylating agent, and as such works by breaking DNA strands while the cancer cell is in its resting phase before cell division, according to the Core Curriculum for Oncology Nursing.
Chemocare.com lists pain at the IV site, nausea, vomiting, mouth sores and low blood counts as common side effects of Adriamycin. Some less common side effects include discoloration of urine after treatment, watering of the eyes, darkening of skin or nail beds and infertility. Common side effects for Cytoxan include nausea, vomiting, low blood counts, hair loss, anorexia, loss of fertility and discoloration of nails. Chemocare.com also lists diarrhea, mouth sores and bladder irritation as rare but possible side effects of Cytoxan. Most chemotherapy drugs, including Adriamycin and Cytoxan, cause generalized fatigue.
Although some side effects, such as hair loss, nail discoloration and lowered blood counts, cannot be prevented, there are some side effects that can. Before each chemotherapy treatment, medications-usually a steroid and anti-nausea medication- are given to reduce the chance of nausea and vomiting. To prevent mouth sores patients are asked to suck on ice chips during the administration of the Adriamycin. The ice shrinks capillaries in the mouth, making it harder for the chemotherapy to reach the cells in the mouth.
Once treatment is over, side effects may be managed at home. If nausea and vomiting occur, physicians will prescribe anti-nausea medications. For those suffering from mouth sores, mouth swishes and pain medications may be used for relief. Rest is often a cure for fatigue in those suffering after treatment. The risk for infection increases due to low blood counts after chemotherapy, so patients are often put on antibiotics for suspected infections or fevers. Although most side effects may be managed at home, those that persist or become severe may require hospitalization.