{"id":11099,"date":"2025-04-24T16:07:26","date_gmt":"2025-04-24T12:37:26","guid":{"rendered":"https:\/\/cedalco.com\/?post_type=dt_portfolio&#038;p=11099"},"modified":"2026-01-09T19:34:26","modified_gmt":"2026-01-09T16:04:26","slug":"adriacedal","status":"publish","type":"dt_portfolio","link":"https:\/\/cedalco.com\/en\/project\/adriacedal\/","title":{"rendered":"AdriaCedal"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"11099\" class=\"elementor elementor-11099 elementor-11093\" data-elementor-post-type=\"dt_portfolio\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f498444 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f498444\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fcacbde\" data-id=\"fcacbde\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-a9fe1d4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a9fe1d4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-5c7a221\" data-id=\"5c7a221\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f04fe80 elementor-widget elementor-widget-image\" data-id=\"f04fe80\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"adriacedal\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6MTExMTgsInVybCI6Imh0dHBzOlwvXC9jZWRhbGNvLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMDRcL2FkcmlhY2VkYWwtMS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"2414\" height=\"2480\" src=\"https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1.png\" class=\"elementor-animation-float attachment-full size-full wp-image-11118\" alt=\"\" srcset=\"https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1.png 2414w, https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1-292x300.png 292w, https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1-997x1024.png 997w, https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1-768x789.png 768w, https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1-1495x1536.png 1495w, https:\/\/cedalco.com\/wp-content\/uploads\/2025\/04\/adriacedal-1-1993x2048.png 1993w\" sizes=\"(max-width: 2414px) 100vw, 2414px\" title=\"\">\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Click on the photo to enlarge <i class=\"fa fa-search-plus\" aria-hidden=\"true\"><\/i><\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-0ae9ab4\" data-id=\"0ae9ab4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ca14146 elementor-widget__width-auto elementor-widget-mobile__width-inherit elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading\" data-id=\"ca14146\" data-element_type=\"widget\" data-widget_type=\"theme-post-title.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">AdriaCedal<sup>\u00ae<\/sup><\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a247d8c elementor-widget elementor-widget-spacer\" data-id=\"a247d8c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f093c73 content-align-mobile-left elementor-widget__width-initial elementor-widget-mobile__width-inherit icon-box-vertical-align-top icon-position-left icon-vertical-align-start elementor-widget elementor-widget-the7_icon_box_widget\" data-id=\"f093c73\" data-element_type=\"widget\" data-widget_type=\"the7_icon_box_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"the7-box-wrapper the7-elementor-widget the7_icon_box_widget-f093c73\">\t\t\t<div class=\"box-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<a class=\"elementor-icon-div\" >\t\t\t\t\t\t<div class=\"elementor-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle-notch\"><\/i>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/a>\t\t\t\t\t\t\t\t<div class=\"box-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"box-heading\">\n\t\t\t\t\t\t\t<a >\t\t\t\t\t\t\t\tGeneric Name\t\t\t\t\t\t\t<\/a>\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"box-description\">Doxorubicin <\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-314c5ec content-align-mobile-left elementor-widget__width-initial elementor-widget-mobile__width-inherit icon-box-vertical-align-top icon-position-left icon-vertical-align-start elementor-widget elementor-widget-the7_icon_box_widget\" data-id=\"314c5ec\" data-element_type=\"widget\" data-widget_type=\"the7_icon_box_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"the7-box-wrapper the7-elementor-widget the7_icon_box_widget-314c5ec\">\t\t\t<div class=\"box-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<a class=\"elementor-icon-div\" >\t\t\t\t\t\t<div class=\"elementor-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle-notch\"><\/i>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/a>\t\t\t\t\t\t\t\t<div class=\"box-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"box-heading\">\n\t\t\t\t\t\t\t<a >\t\t\t\t\t\t\t\tBrand Name\t\t\t\t\t\t\t<\/a>\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"box-description\"><sup>\u00ae<\/sup>AdriaCedal<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fc46607 elementor-widget__width-initial elementor-widget-mobile__width-inherit content-align-mobile-left icon-box-vertical-align-top icon-position-left icon-vertical-align-start elementor-widget elementor-widget-the7_icon_box_widget\" data-id=\"fc46607\" data-element_type=\"widget\" data-widget_type=\"the7_icon_box_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"the7-box-wrapper the7-elementor-widget the7_icon_box_widget-fc46607\">\t\t\t<div class=\"box-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<a class=\"elementor-icon-div\" >\t\t\t\t\t\t<div class=\"elementor-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle-notch\"><\/i>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/a>\t\t\t\t\t\t\t\t<div class=\"box-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"box-heading\">\n\t\t\t\t\t\t\t<a >\t\t\t\t\t\t\t\tDrug Class\t\t\t\t\t\t\t<\/a>\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"box-description\">Antineoplastic agent, Anthracycline <\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8b82e48 elementor-widget__width-initial elementor-widget-mobile__width-inherit content-align-mobile-left icon-box-vertical-align-top icon-position-left icon-vertical-align-start elementor-widget elementor-widget-the7_icon_box_widget\" data-id=\"8b82e48\" data-element_type=\"widget\" data-widget_type=\"the7_icon_box_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"the7-box-wrapper the7-elementor-widget the7_icon_box_widget-8b82e48\">\t\t\t<div class=\"box-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<a class=\"elementor-icon-div\" >\t\t\t\t\t\t<div class=\"elementor-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle-notch\"><\/i>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/a>\t\t\t\t\t\t\t\t<div class=\"box-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"box-heading\">\n\t\t\t\t\t\t\t<a >\t\t\t\t\t\t\t\tDosage Form\t\t\t\t\t\t\t<\/a>\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"box-description\">Concentrate for Solution for Infusion\n2 mg\/ml, 10 mg & 50 mg<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-85778be the7-e-tabs-view-vertical icon-align-left elementor-widget elementor-widget-the7-tabs\" data-id=\"85778be\" data-element_type=\"widget\" data-settings=\"{&quot;accordion_breakpoint&quot;:&quot;mobile&quot;}\" data-widget_type=\"the7-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t<div class=\"the7-e-tabs-wrapper\">\n\t\t<div class=\"the7-e-tabs-nav-wrapper\">\n\t\t\t<div class=\"the7-e-tabs-nav-scroll-wrapper\">\n\t\t\t\t<div class=\"the7-e-tabs-nav\" role=\"tablist\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1391\" class=\"the7-e-tab-title\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"the7-e-tab-content-1391\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-virus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tIndications\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1392\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1392\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-virus-slash\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tContradications\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1393\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1393\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-list-ul\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tWarnings and Precautions\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1394\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1394\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-hand-holding-medical\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tDosage and Administration\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1395\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1395\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"far fa-bell\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tAdverse Reactions\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1396\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"6\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1396\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fab fa-confluence\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tDrug Interactions\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1397\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"7\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1397\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-baby\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tUse in pregnancy and lactation\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<div id=\"the7-e-tab-title-1398\" class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"8\" role=\"tab\" tabindex=\"-1\" aria-controls=\"the7-e-tab-content-1398\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-box\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tStorage Conditions\t\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"the7-e-tab-nav-button left-button\"><\/div>\n\t\t\t<div class=\"the7-e-tab-nav-button right-button\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"the7-e-tabs-content\" role=\"tablist\" aria-orientation=\"vertical\">\n\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"1\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"elementor-tab-content-1391\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-virus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tIndications\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1391\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1391\" tabindex=\"0\" hidden=\"false\"><p>Acute leukaemia, Wilms&#8217; tumour, neuroblastoma, soft tissue and bone sarcomas, breast carcinoma, lymphomas of both Hodgkin&#8217;s and non-Hodgkin&#8217;s type, bronchogenic carcinoma, thyroid carcinoma, hepatomas, ovarian carcinoma, etc. AdriaCedal\u00ae is also indicated by Intravesical administration in the primary management of non-metastatic carcinoma of the bladder<\/p><ul><li>Indolent non-Hodgkin&#8217;s lymphomas as monotherapy in patients who have progressed during or within 6 months following treatment with rituximab or a rituximab containing regimen.<\/li><\/ul><p>Front line treatment of multiple myeloma (Durie-Salmon stage II with progress or stage III) in combination with prednisone for patients older than 65 years who are not eligible for autologous stem cell transplantation and who have clinical neuropathy at time of diagnosis precluding the use of thalidomide or bortezomib containing treatment.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"2\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1392\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-virus-slash\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tContradications\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1392\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1392\" tabindex=\"0\" hidden=\"hidden\"><p>General Contraindications:<\/p><p>Adriacedal\u00ae is contraindicated in patients with known hypersensitivity to doxorubicin, any of the product\u2019s components, or to other anthracyclines.<\/p><p><strong>Contraindications for Intravenous (IV) Use:<\/strong><\/p><ul><li>Persistent myelosuppression or severe stomatitis caused by prior treatment with antitumour agents or radiotherapy<\/li><li>Active generalized infections<\/li><li>Severe cardiac arrhythmias<\/li><li>Severe myocardial insufficiency<\/li><li>Recent myocardial infarction<\/li><li>Severe hepatic impairment<\/li><li>Prior administration of maximum cumulative doses of doxorubicin, daunorubicin, epirubicin, idarubicin, or other anthracyclines and anthracenediones<\/li><\/ul><p><strong>Contraindications for Intravesical Use:<\/strong><\/p><ul><li>Invasive bladder tumours that have penetrated the bladder wall<\/li><li>Urinary tract infections<\/li><li>Bladder inflammation (cystitis)<\/li><li>Conditions preventing proper bladder catheterisation (e.g., due to large intravesical tumours)<\/li><li>Haematuria (presence of blood in the urine)<\/li><\/ul><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"3\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1393\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-list-ul\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tWarnings and Precautions\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1393\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1393\" tabindex=\"0\" hidden=\"hidden\"><p><u>General<\/u><\/p><p>Adriacedal should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents.<\/p><p>Adriacedal is not an antimicrobial agent.<\/p><p>Patients should recover from acute toxicities of prior cytotoxic treatment (such as stomatitis, neutropenia, thrombocytopenia and generalised infections) before beginning treatment with doxorubicin.<\/p><p>Initial treatment with Adriacedal requires close observation of the patient and extensive laboratory monitoring.<\/p><p>It is strongly recommended therefore that patients be hospitalised at least during the first phase of treatment. Blood count and liver function tests should be carried out prior to each Adriacedal treatment.<\/p><p>Adriacedal solution should be handled with care. If either of the preparations comes in<\/p><p>contact with the skin or mucosae, the appropriate areas should be washed thoroughly with soap and water.<\/p><p>For intravenous or intravesical use only. Severe local tissue necrosis will occur if there is extravasation during administration. Adriacedal must not be given by the intramuscular or subcutaneous route.<\/p><p>Serious irreversible myocardial toxicity with delayed congestive failure often unresponsive to any cardiac supportive therapy may be encountered as total dosage approaches 550 mg\/m<sup>2<\/sup>. This toxicity may occur at lower cumulative doses in patients with prior mediastinal irradiation or on concurrent cyclophosphamide therapy. Dosage should be reduced in patients with impaired hepatic function. Severe myelosuppression may occur.<\/p><p><u>Cardiac Function:<\/u> Special attention must be given to the cardiac toxicity exhibited by doxorubicin. Cardiotoxicity is a risk of anthracycline treatment that may be manifested by early (i.e., acute) or late (i.e., delayed) events. The cardiac abnormalities caused by treatment can be separated into 2 categories:<\/p><ol><li>Electrocardiogram (ECG) alterations<\/li><li>Congestive heart failure (CHF)<\/li><\/ol><p>Early (i.e., Acute) Events: Early cardiotoxicity of doxorubicin consists mainly of sinus tachycardia and\/or ECG abnormalities such as non-specific ST-T wave changes. Tachyarrhythmias, including premature ventricular contractions, ventricular tachycardia and bradycardia, as well as atrioventricular and bundle-branch block have also been reported. These effects do not usually predict subsequent development of delayed cardiotoxicity, are rarely of clinical importance and are generally not a consideration for the discontinuation of doxorubicin treatment. ECG changes following doxorubicin treatment occur in about 10% of patients at all dose levels of doxorubicin, are usually reversible and do not appear to be related to the subsequent development of congestive cardiac failure.<\/p><p>Late (i.e., Delayed) Events: Delayed cardiotoxicity usually develops late in the course of therapy with doxorubicin or within 2 to 3 months after treatment termination, but later events several months to years after completion of treatment have also been reported. Delayed cardiomyopathy is manifested by reduced left ventricular ejection fraction (LVEF) and\/or signs and symptoms of CHF such as dyspnoea, pulmonary oedema, dependent oedema, cardiomegaly and hepatomegaly, oliguria, ascites, pleural effusion and gallop rhythm. Subacute effects such as pericarditis\/myocarditis have also been reported. Life-threatening CHF is the most severe form of anthracycline-induced cardiomyopathy and represents the cumulative dose-limiting toxicity of the drug.<\/p><p>The following measures may identify patients with early cardiomyopathy: progressive flattening or inversion of the T-waves (mainly in the left precordial leads), low QRS voltage, prolonged systolic time interval, reduced ejection fraction (echocardiography or by cardiac pool scanning) or cardiac biopsy showing characteristic electro microscopic changes. Cardiomyopathy induced by doxorubicin is frequently fatal. Cardiac failure is often not favourably affected by presently known medical or physical therapy for cardiac support. Early clinical diagnosis of drug induced heart failure appears to be essential for successful treatment with digitalis, diuretics, low salt diet and bed rest.<\/p><p>Although uncommon, acute left ventricular failure has occurred, particularly in patients who have received total dosage of the drug exceeding the currently recommended limit of 550 mg\/m2. For this reason, cardiac function should be assessed before patients undergo treatment with doxorubicin and must be carefully monitored throughout therapy to minimise the risk of incurring severe cardiac impairment. The risk may be decreased through regular monitoring of LVEF during the course of treatment with prompt discontinuation of doxorubicin at the first sign of impaired function. The appropriate quantitative method for repeated assessment of cardiac function (evaluation of LVEF) includes multi-gated radionuclide angiography (MUGA)<\/p><p>or echocardiography (ECHO). A baseline cardiac evaluation with an ECG and either a MUGA scan or an ECHO is recommended, especially in patients with risk factors for increased cardiotoxicity. Repeated MUGA or ECHO determinations of LVEF should be performed, particularly with higher, cumulative anthracycline doses. The technique used for assessment should be consistent throughout follow-up. Severe cardiac toxicity may occur precipitously without antecedent ECG changes.<\/p><p>Baseline ECG and periodic follow-up ECG during, and immediately after drug therapy is an advisable precaution. Transient ECG changes, such as T-wave flattening, S-T depression and arrhythmias are not considered indications for suspension of doxorubicin therapy. A persistent reduction in the voltage of the QRS wave is presently considered more specifically predictive for cardiac toxicity. If this occurs, the benefit of continued therapy must be carefully evaluated against the risk of producing irreversible cardiac damage.<\/p><p>A decrease of the LVEF is the most predictive event related to chronic, cumulative dose-dependent cardiomyopathy. When a pre-treatment (baseline) assessment of LVEF is available, this parameter can be used as an indicator of cardiac function throughout therapy. As a general rule, in patients with normal baseline LVEF (\u226550%), an absolute decrease of \u226510% or a decline below the 50% threshold level are indicative of a deterioration of cardiac function and the continuation of doxorubicin treatment under such conditions has to be carefully evaluated.<\/p><p>The probability of developing impaired myocardial function based on a combined index of signs, symptoms and a decline in LVEF can be estimated to be around 1-2% at a cumulative dose of 300 mg\/m2; this probability slowly increases up to the total cumulative dose of 450-550 mg\/m2. Thereafter, the risk of developing CHF increases more steeply, and it is recommended not to exceed the total cumulative dose of 550 mg\/m2.<\/p><p>Cardiac function must be carefully monitored in patients receiving high cumulative doses and in those with risk factors. However, cardiac toxicity with doxorubicin may occur at lower cumulative doses whether or not cardiac risk factors are present.<\/p><p>Risk factors for cardiac toxicity include active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal\/pericardial area, previous therapy with anthracyclines or anthracenediones, concomitant use of drugs with the ability to suppress cardiac contractility or other cardioactive compounds (e.g., calcium channel blocking drugs) or concomitant use of other potentially cardiotoxic drugs (e.g., cyclophosphamide, 5-fluorouracil or trastuzumab). Anthracyclines including doxorubicin should not be administered in combination with other cardiotoxic agents unless the patient&#8217;s cardiac function is closely monitored. Patients receiving anthracyclines after stopping treatment with other cardiotoxic agents, especially those with long half-lives such as trastuzumab (variable half-life; washout<\/p><p>period up to 7 months), may also be at an increased risk of developing cardiotoxicity. Note: Trastuzumab emtansine has a shorter half-life of approximately 4 days. The half-life of trastuzumab is variable. Trastuzumab may persist in the circulation for up to 7 months. Therefore, physicians should avoid anthracycline-based therapy for up to 7 months after stopping trastuzumab when possible. If anthracyclines are used before this time, careful monitoring of cardiac function is recommended.<\/p><p>For patients who have had mediastinal irradiation, concurrent high dose cyclophosphamide or hypertensive cardiomegaly it is recommended that the cumulative total lifetime dose of doxorubicin (including related drugs such as daunorubicin) be less than 450 mg\/m2 body surface area. Congestive heart failure and\/or cardiomyopathy may be encountered several weeks after discontinuation of doxorubicin therapy.<\/p><p>The total (cumulative) dose levels of doxorubicin correlate with the incidence of drug induced congestive cardiac failure (cardiomyopathy). Limitation of the total dose of doxorubicin to 500 mg\/m2 reduces the risk of drug induced cardiomyopathy. At the cellular level, cardiotoxicity induced by doxorubicin is due to myocyte damage. Furthermore, as a consequence of the inhibition of cellular proliferation not only of neoplastic cells but also normal cells, cardiac muscle cells are unable to regenerate.<\/p><p>Microscopical examination of endocardial biopsies shows two major types of myocyte damage: 1. Cells totally or partially devoid of myofibrillar content, even though the nucleus and mitochondria are intact.<\/p><ol start=\"2\"><li>Vacuolar degeneration.<\/li><\/ol><p>Damage to the myocardial muscle occurs with very little inflammatory reaction, muscle fibres appear to fade away. The clinical spectrum of doxorubicin toxicity ranges from subtle changes in ventricular function that can be detected only by sophisticated studies to gross congestive cardiomyopathy with symptoms and signs of advanced congestive heart failure.<\/p><p>It is probable that the toxicity of doxorubicin and other anthracyclines or anthracenediones is additive.<\/p><p>Animal studies have indicated a possible relationship between the inhibition by doxorubicin of the mitochondrial biosynthesis of Coenzyme Q10 and cardiotoxicity induced by<\/p><p>doxorubicin. Other studies have suggested that Vitamin E and other free radical acceptors may prevent doxorubicin toxicity.<\/p><p>Haematologic Toxicity:<\/p><p>As with other cytotoxic agents, doxorubicin may produce myelosuppression. Haematologic profiles should be assessed before and during each cycle of therapy with doxorubicin, including differential white blood cell (WBC) counts. A dose-dependent, reversible leucopenia and\/or granulocytopenia (neutropenia) is the predominant manifestation of doxorubicin haematologic toxicity and is the most common acute dose-limiting toxicity of this drug. Leucopenia and neutropenia are generally more severe with high-dose schedules, reaching the nadir in most cases between days 10-14 after drug administration; this is usually transient with the WBC\/neutrophil counts returning to normal values in<\/p><p>most cases by day 21. White blood cell counts as low as 1000\/mm3 are to be expected during treatment with appropriate doses of doxorubicin.<\/p><p>Myelosuppression accompanies effective doxorubicin treatment in almost 100% of patients. Leucopenia is the predominant effect with thrombocytopenia and anaemia occurring less frequently. Red blood cell and platelet levels should also be monitored. Myelosuppression is more common in patients who have had extensive radiotherapy, bone infiltration by tumour, impaired liver function when appropriate dosage reduction has not been adopted and simultaneous treatment with other myelosuppressive agents. Haematologic toxicity may require dose reduction, suspension or delay of AdriacedalR therapy.<\/p><p>When using doxorubicin as part of chemotherapy regimens which combine drugs of similar pharmacological effects (i.e., cytotoxicity) additive toxicity is likely to occur. Such additive toxicity has to be taken into consideration especially with regard to bone marrow function. Doxorubicin is a powerful but temporary immunosuppressant agent. Appropriate measures should be taken to prevent secondary infection. Clinical consequences of severe myelosuppression include fever, infection, sepsis\/septicaemia, septic shock, haemorrhage, tissue hypoxia or death.<\/p><p>Secondary Leukaemia:<\/p><p>Secondary leukaemia, with or without a pre-leukaemic phase, has been reported in patients treated with anthracyclines including doxorubicin. Secondary leukaemia is more common when such drugs are given in combination with DNA-damaging antineoplastic agents, in combination with radiotherapy, when patients have been heavily pre-treated with cytotoxic<\/p><p>drugs, or when doses of the anthracyclines have been escalated. This has been noted in the adjuvant and neoadjuvant setting. These leukaemias can have a 1-3 year latency period. Gastrointestinal:<\/p><p>Doxorubicin is emetogenic, Mucositis is a frequent and painful complication of doxorubicin treatment but is less common than myelosuppression. Mucositis\/stomatitis generally appears early after drug administration, most commonly developing 5 to 10 days after treatment. It typically begins as a burning sensation in the mouth and pharynx. The mucositis may involve the vagina, rectum and oesophagus and if severe, may progress over a few days to mucosal ulcerations with risk of secondary infection. Most patients recover from this adverse event by the third week of therapy. Retrospective comparison of the incidence of mucositis suggests that it is less frequent as the intervals between doses increase. Mucositis may be severe in patients who have had previous irradiation to the mucosae.<\/p><p>Obesity:<\/p><p>The systemic clearance of doxorubicin has been found to be reduced in obese patients; such patients have to be carefully monitored if undergoing treatment with the maximum recommended doses of the drug.<\/p><p>Effects at Site of Injection:<\/p><p>Phlebosclerosis may result from an injection into a small vessel or from repeated injections into the same vein. Following the recommended administration procedures may minimise the risk of phlebitis\/thrombophlebitis at the injection site.<\/p><p>Extravasation:<\/p><p>Extravasation of doxorubicin during intravenous injection may produce local pain (a burning or stinging sensation), severe tissue lesions (vesication, severe cellulitis) and necrosis. if signs or symptoms of extravasation occur during intravenous administration of doxorubicin, the drug infusion should be immediately stopped.<\/p><p>Tumour-Lysis Syndrome:<\/p><p>Like other cytotoxic drugs, doxorubicin may induce hyperuricaemia as a consequence of the extensive purine catabolism that accompanies rapid drug-induced lysis of neoplastic cells (tumour-lysis syndrome). The clinician should monitor the patient&#8217;s blood uric acid level, potassium, calcium phosphate and creatinine. Supportive and pharmacologic measures should be used to control this problem. Hydration, urine alkalinisation and prophylaxis with allopurinol to prevent hyperuricaemia may minimise potential complications of tumour-lysis syndrome.<\/p><p>Immunosuppressant Effects\/Increased Susceptibility to Infections:<\/p><p>Administration of live or live-attenuated vaccines in patients immunocompromised by chemotherapeutic agents, including doxorubicin, may result in serious or fatal infections. Vaccination with a live vaccine should be avoided in patients receiving doxorubicin. Killed or inactivated vaccines may be administered; however, the response to such vaccines may be diminished.<\/p><p>During treatment with the drug, patients should avoid contact with people who have received polio vaccine<\/p><p>Other:<\/p><p>Doxorubicin may potentiate the toxicity of other anticancer therapies. Exacerbation of cyclophosphamide induced haemorrhagic cystitis, mucositis induced by radiotherapy and enhanced hepatotoxicity of 6-mercaptopurine have been reported. Radiation-induced toxicities (myocardium, mucosae, skin and liver) have also been reported.<\/p><p>As with other cytotoxic agent, thrombophlebitis and thromboembolic phenomena, including pulmonary embolism (in some cases fatal), have been coincidentally reported with the use of doxorubicin.<\/p><p>Doxorubicin imparts a red colouration to the urine for 1-2 days after administration and patients should be advised to expect this during active therapy.<\/p><p>Intravesical Route:<\/p><p>Administration of doxorubicin by the intravesical route may produce symptoms of chemical cystitis (such as dysuria, polyuria, nocturia, stranguria, haematuria, bladder discomfort and necrosis of the bladder wall) and bladder constriction. Special attention is required for catheterisation problems (e.g., urethral obstruction due to massive intravesical tumours). Urine cytologies and blood counts should be monitored monthly and cytoscopic examinations should be performed at regular intervals.<\/p><p>Embryo-fetal Toxicity:Doxorubicin can cause genotoxicity. An effective method of contraception is required for both male and female patients during and for a period after treatment with doxorubicin. Patients desiring to have children after completion of therapy should be advised to obtain genetic counselling if appropriate and available.<\/p><p>Effects on Laboratory Tests: No data available.<\/p><p>Instructions to be Given to Patients:<\/p><p>Patients should inform their physicians immediately if pain develops at the injection site. Nausea and vomiting may be expected 3-6 hours after drug treatment and may last for several hours.<\/p><p>Patients should be advised to expect a red colouration to the urine (not indicative of haematuria) for 1 to 2 days after each administration of Adriacedal.<\/p><p>Alopecia (hair loss) should be expected 1 to 2 weeks after the initiation of Adriacedal treatment. Hair loss may be complete but hair always returns after termination of treatment. NB. Scalp tourniquets inflated to above systolic blood pressure and left in situ for 30 minutes over the time of Adriacedal treatment reduces the probability of alopecia.<\/p><p>Anorexia may be expected for 24 hours following each treatment and occasionally may persist for several days.<\/p><p>Hyperpigmentation usually in the hands, nails and buccal mucosa may develop in patients receiving Adriacedal. Patients should be advised that this condition does not usually improve after termination of treatment.<\/p><p>Infertility in both sexes is usual in patients receiving Adriacedal. Amenorrhoea is frequent and in pre-menopausal women, regular menstruation usually returns a few months after termination of Adriacedal therapy. This is often accompanied by normal fertility.<\/p><p>Male patients should be advised that oligospermia or azoospermia may be permanent. There is a possibility that fertility may return several years after ceasing therapy. Men undergoing Adriacedal therapy should be advised to use effective contraceptive measures.<\/p><p>Patients should be instructed to inform their physicians of any prior abnormal heart or liver conditions, as this information is vital to the formulation of appropriate dosage regimes.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"4\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1394\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-hand-holding-medical\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tDosage and Administration\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1394\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1394\" tabindex=\"0\" hidden=\"hidden\"><p><strong>Dosage:<\/strong><\/p><p>Careful administration of Adriacedal\u00ae can reduce the risk of perivenous infiltration, a condition in which the drug leaks outside the vein into surrounding tissue. This precaution may also help minimize local adverse reactions, such as urticaria (hives) and erythematous streaking (redness along the veins).<\/p><p>The recommended dosage for Adriacedal\u00ae is 60 to 75 mg\/m\u00b2, administered as a single intravenous injection every 21 days. When treating patients with compromised bone marrow reserves\u2014whether due to advanced age, prior therapies, or neoplastic (cancerous) marrow infiltration\u2014the lower end of the dosage range should be selected.<\/p><p>An alternative dosing regimen consists of 30 mg\/m\u00b2 per day, given on three consecutive days, and repeated every four weeks. Although these regimens are designed for adults, they may also be appropriate for pediatric patients, depending on clinical judgment and patient-specific factors.<\/p><p>The recommended lifetime cumulative dose limit for Doxorubicin (the active ingredient in Adriacedal\u00ae) is 550 mg\/m\u00b2 of body surface area. However, Adriacedal\u00ae has also been administered via intra-arterial infusion, typically over 1 to 3 days, at total doses ranging from 45 to 100 mg.<\/p><p>For patients aged 70 years or older, the total cumulative dose should be more strictly limited, with a recommended maximum of 450 mg\/m\u00b2 of body surface area.<\/p><p><strong>Method of Administration<\/strong>:<\/p><p><strong>Handling Precautions<\/strong><\/p><p>Adriacedal must be handled with great care. If contact with the skin occurs, the affected area should be washed thoroughly with soap and water.<\/p><p><strong>Protective Measures<\/strong><\/p><ul><li>Due to the toxic nature of this substance, the following protective guidelines must be observed:<\/li><li>Personnel should be trained in proper techniques for the reconstitution and handling of Adriacedal.<\/li><li>Pregnant staff should not be assigned to handle this drug.<\/li><li>Anyone handling doxorubicin must wear appropriate protective gear, including goggles, gowns, disposable gloves, and masks.<\/li><li>Reconstitution should be performed in a designated area, preferably under a laminar flow hood. The work surface should be covered with disposable, plastic-backed absorbent paper.<\/li><li>All items used for reconstitution, administration, or cleaning (including gloves) should be placed in high-risk waste disposal bags and incinerated at high temperatures.<\/li><\/ul><p><strong>In Case of Spillage or Leakage<\/strong><\/p><p>Spills should be treated by soaking with a dilute sodium hypochlorite solution (1% available chlorine), followed by thorough rinsing with water. All cleaning materials should be disposed of in the manner described above.<\/p><p><strong>In Case of Contact<\/strong><\/p><p><strong>For skin contact:<\/strong> Wash the affected area thoroughly with soap and water or a sodium bicarbonate solution. Avoid scrubbing the skin with a brush.<\/p><p><strong>For eye contact:<\/strong> Retract the eyelids and flush the eye(s) with copious amounts of water for at least 15 minutes. Seek immediate medical evaluation.<\/p><p>Always wash hands thoroughly after removing gloves.<\/p><p><strong>Intravenous Administration<\/strong><\/p><p>It is recommended that Adriacedal\u00ae be slowly injected into the tubing of a freely running intravenous infusion of either 0.9% sodium chloride or 5% glucose solution. The tubing should be connected to a butterfly needle inserted preferably into a large vein. The rate of administration depends on the vein size and the dose, but it should not be given in less than 3\u20135 minutes.<\/p><p>Note: Direct push injections are not recommended due to the risk of extravasation, which may occur even when there is blood return upon needle aspiration.<\/p><p>Signs such as local erythematous streaking along the vein or facial flushing may suggest that the administration is too rapid. A burning or stinging sensation may indicate perivenous infiltration. In such cases, the infusion should be immediately stopped and restarted in a different vein.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"5\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1395\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"far fa-bell\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tAdverse Reactions\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1395\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1395\" tabindex=\"0\" hidden=\"hidden\"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them. Side effects with Adriacedal may include:<\/p><p>Frequency not always defined.<\/p><ul><li><strong>Cardiovascular:<\/strong> Acute cardiotoxicity: Atrioventricular block, bradycardia, bundle branch block, ECG abnormality, extrasystoles (atrial or ventricular), nonspecific ST or T wave changes on ECG, sinus tachycardia, supraventricular tachycardia, tachyarrhythmia, ventricular tachycardia Delayed cardiotoxicity: Cardiac failure (manifestations include ascites, cardiomegaly, dyspnea, edema, gallop rhythm, hepatomegaly, oliguria, pleural effusion, pulmonary edema, tachycardia), decreased left ventricular ejection fraction, myocarditis, pericarditis<\/li><li><strong>Central nervous system<\/strong>: Malaise<\/li><li><strong>Dermatologic:<\/strong> Alopecia, discoloration of sweat, pruritus, skin photosensitivity, skin rash; <strong>urticaria Endocrine &amp; metabolic: <\/strong>Amenorrhea, dehydration, hyperuricemia<\/li><li><strong>Gastrointestinal: <\/strong>Abdominal pain, anorexia, diarrhea, discoloration of saliva, gastrointestinal ulcer, mucositis, nausea, vomiting<\/li><li><strong>Genitourinary:<\/strong> Urine discoloration, infertility (may be temporary)<\/li><li><strong>Hematologic &amp; oncologic:<\/strong> Leukopenia (\u226475%; nadir: 10 to 14 days; recovery: by day 21), neutropenia (\u226475%; nadir: 10 to 14 days; recovery: by day 21), anemia, thrombocytopenia Local: Post-injection flare<\/li><li><strong>Neuromuscular &amp; skeletal:<\/strong> Weakness<\/li><li><strong>Ophthalmic: <\/strong>Discoloration of tears<\/li><li><strong>Miscellaneous: <\/strong>Necrosis (colon), radiation recall phenomenon<\/li><li>&lt;1%, postmarketing, and\/or case reports: Acute myelocytic leukemia (secondary), anaphylaxis, azoospermia, chills, coma (when in combination with cisplatin or vincristine), conjunctivitis, dysgeusia (Rehwaldt 2009), febrile neutropenia, fever, gonadal disease (gonadal impairment; children), growth suppression (prepubertal), hepatitis, hyperpigmentation (nail, oral mucosa, skin), hypersensitivity reaction (systemic; including angioedema, dysphagia, and dyspnea, pruritus, urticaria), increased serum bilirubin, increased serum transaminases, infection, keratitis, lacrimation, myelodysplastic syndrome, oligospermia, onycholysis, peripheral neurotoxicity (with intra-arterial doxorubicin), phlebosclerosis, pneumonitis (radiation recall; children), seizure (when in combination with cisplatin or vincristine), sepsis, shock, Stevens- Johnson syndrome, toxic epidermal necrolysis, typhlitis (neutropenic)<\/li><\/ul><p>Reporting of suspected adverse reactions<\/p><p>Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit\/risk balance of the medicinal product. Please report any adverse drug reactions via contacting Cedal Nano.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"6\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"6\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1396\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fab fa-confluence\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tDrug Interactions\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1396\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"6\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1396\" tabindex=\"0\" hidden=\"hidden\"><p>Doxorubicin is a major substrate of cytochrome P450 CYP3A4 and CYP2D6 and P-glycoprotein (P-gp). Clinically significant interactions have been reported with inhibitors of CYP3A4, CYP2D6 and\/or P-gp (e.g., verapamil) resulting in increased concentration and clinical effect of doxorubicin. Inducers of CYP3A4 (e.g., phenobarbital, phenytoin, St. John&#8217;s Wort) and P-gp inducers may decrease the concentration of doxorubicin.<\/p><p>-Doxorubicin is mainly used in combination with other cytotoxic agents. Additive toxicity may occur, especially with regard to bone marrow\/haematologic and gastrointestinal effects. &#8211; Adjuvant Chemotherapy Involving Doxorubicin: It is not recommended that doxorubicin be used routinely as adjuvant chemotherapy in any tumour category. The activity of doxorubicin in combination with other drugs is affected not only by the nature of the drug itself, but also by the schedule of administration. It is strongly recommended that in situations where doxorubicin is intended for use as adjuvant chemotherapy, higher authorities as well as the Hospital Ethical Committee be consulted.<\/p><p>&#8211; Cyclophosphamide: Concurrent cyclophosphamide treatment sensitises the heart to the cardiotoxic effects of doxorubicin. Doxorubicin may exacerbate cyclophosphamide cystitis. &#8211; Ciclosporin: The addition of ciclosporin to doxorubicin may result in increases in area under the concentration-time curve (AUC) for both doxorubicin and doxorubicinol, possibly due to a decrease in clearance of the parent drug and a decrease in metabolism of doxorubicinol. Literature reports suggest that adding ciclosporin to doxorubicin results in more profound and prolonged hematologic toxicity than that observed with doxorubicin alone. Coma and seizures have also been described with concomitant administration of ciclosporin and doxorubicin. &#8211; Heparin: Doxorubicin should not be mixed with heparin since it has been reported that these drugs are incompatible to the extent that a precipitate may form.<\/p><p>&#8211; Mediastinal Radiotherapy: Concurrent mediastinal radiotherapy and doxorubicin may be associated with enhanced myocardial toxicity of doxorubicin.<\/p><p>&#8211; Paclitaxel: Paclitaxel can cause increased plasma-concentration of doxorubicin and\/or its metabolites when given prior to doxorubicin. Certain data indicate that this effect is minor when anthracycline is administered prior to paclitaxel.<\/p><p>&#8211; Propranolol: In view of the finding that doxorubicin and propranolol have both been shown to inhibit cardiac mitochondrial CoQ10 enzymes it is possible that such a drug interaction may result in an additive cardiotoxic effect.<\/p><p>&#8211; Radiotherapy: Concurrent radiotherapy and doxorubicin treatment may be associated with increased radiation toxicity, i.e., skin reactions and mucositis.<\/p><p>&#8211; Sorafenib: Both increases (21% -47%) and no change in the AUC of doxorubicin were observed with concomitant treatment with sorafenib 400 mg twice daily. The clinical significance of these findings is unknown.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"7\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"7\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1397\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-baby\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tUse in pregnancy and lactation\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1397\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"7\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1397\" tabindex=\"0\" hidden=\"hidden\"><p><strong>Pregnancy<\/strong><\/p><p>Pregnancy There is no information on the drug&#8217;s use in pregnancy; therefore, the drug should not be used in pregnant women or those likely to become pregnant unless the expected benefit outweighs any potential risk. If a woman receives doxorubicin during pregnancy or becomes pregnant while taking the drug, she should be apprised of the potential hazard to the fetus. Although animal studies have not demonstrated teratogenic activity due to doxorubicin treatment, an embryotoxic action is evident. Studies with rabbits and rats have revealed a decreased weight gain and a higher incidence of resorbed fetuses. No greater incidence of gross, visceral or skeletal malformations or of post-natal deaths has been observed. Dose-related mutagenic effects of doxorubicin have been reported to produce severe chromosomal aberrations in in vitro studies. In view of this activity, the use of this drug in pregnant women is not recommended.<\/p><p><strong>Breast feeding<\/strong><\/p><p>Doxorubicin is secreted in breast milk. Because of the potential for serious reactions in nursing infants from doxorubicin, women should be instructed not to breast-feed while undergoing treatment with doxorubicin and for at least 10 days after last dose.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t\t<div class=\"the7-e-tab-item-wrapper\" data-tab=\"8\">\n\t\t\t\t\t<div class=\"the7-e-tab-title\" aria-selected=\"false\" data-tab=\"8\" role=\"tab\" tabindex=\"-1\" aria-controls=\"elementor-tab-content-1398\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t<span class=\"the7-e-tab-icon elementor-icon\" aria-hidden=\"true\"><i class=\"fas fa-box\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t<h5 class=\"the7-e-tab-title-text\">\n\t\t\t\t\t\t\tStorage Conditions\t\t\t\t\t\t<\/h5>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"the7-e-tab-content-1398\" class=\"the7-e-tab-content the7-e-tab-text-content\" data-tab=\"8\" role=\"tabpanel\" aria-labelledby=\"the7-e-tab-title-1398\" tabindex=\"0\" hidden=\"hidden\"><p>Adriacedal is supplied in vials containing doxorubicin hydrochloride 10 mg or 50 mg (2 mg\/mL) as a concentrate for solution for infusion.<\/p><p><strong>Handling and Disposal:<\/strong><\/p><p>Due to the toxic nature of this substance, the following protective recommendations must be observed:<\/p><ul><li>Personnel must be properly trained in safe reconstitution and handling techniques.<\/li><li>Pregnant staff should not be involved in the handling of this product.<\/li><li>Personnel handling doxorubicin should wear protective clothing, including goggles, gowns, disposable gloves, and masks.<\/li><li>Reconstitution should take place in a designated area, preferably under a laminar flow hood. The work surface must be covered with disposable, plastic-backed absorbent paper.<\/li><li>All materials used for reconstitution, administration, or cleaning\u2014including gloves\u2014must be disposed of in high-risk waste-disposal bags and incinerated at high temperatures.<\/li><\/ul><p>In case of spillage or leakage, clean the area with a dilute sodium hypochlorite solution (1% available chlorine), ideally by soaking, followed by thorough rinsing with water. Dispose of all cleaning materials according to the above procedures.<\/p><p>In case of skin contact, immediately wash the affected area thoroughly with soap and water or a sodium bicarbonate solution. Avoid using a scrub brush or any method that could abrade the skin.<\/p><p>In case of eye contact, retract the eyelid(s) and flush the eyes with copious amounts of water for at least 15 minutes. Seek medical attention promptly.<br \/>Always wash hands thoroughly after removing gloves.<\/p><p><strong>Storage:<\/strong><\/p><ul><li>Store Adriacedal in a refrigerator at 2\u00b0C to 8\u00b0C.<\/li><li>Protect from light exposure and do not freeze.<\/li><li>Refrigerated storage may lead to the formation of a gelled product. If this occurs, allow the product to sit at room temperature (15\u00b0C to 30\u00b0C) for 2 to 4 hours, after which it will return to a slightly viscous, mobile solution.<\/li><li>Store in the original packaging to ensure protection from light.<\/li><li>After dilution, the solution should be used within 1 hour. If not used within this time, the diluted product must be discarded.<\/li><\/ul><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<span class=\"item-divider\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t<\/div>\n\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-f6db1df elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f6db1df\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-00af72e\" data-id=\"00af72e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2cf559b icon-box-vertical-align-center elementor-widget__width-auto elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile content-align-left icon-position-left icon-vertical-align-start elementor-widget elementor-widget-the7_icon_box_widget\" data-id=\"2cf559b\" data-element_type=\"widget\" data-widget_type=\"the7_icon_box_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"the7-box-wrapper the7-elementor-widget the7_icon_box_widget-2cf559b\">\t\t\t<div class=\"box-content-wrapper\">\n\t\t\t\t\t\t\t\t<div class=\"box-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"box-heading\">\n\t\t\t\t\t\t\t<a href=\"\/wp-content\/uploads\/2023\/02\/5FUEnglish.docx\">\t\t\t\t\t\t\t\tProduct Description File\t\t\t\t\t\t\t<\/a>\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e992db8 elementor-share-buttons--view-icon elementor-share-buttons--skin-minimal elementor-share-buttons--shape-circle elementor-grid-mobile-6 elementor-share-buttons--align-left elementor-share-buttons--color-custom elementor-widget__width-auto elementor-grid-0 elementor-widget elementor-widget-share-buttons\" data-id=\"e992db8\" data-element_type=\"widget\" data-widget_type=\"share-buttons.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-grid\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_twitter\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on twitter\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<i class=\"fab fa-twitter\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_linkedin\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on linkedin\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<i class=\"fab fa-linkedin\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_whatsapp\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on whatsapp\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<i class=\"fab fa-whatsapp\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_telegram\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on telegram\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<i class=\"fab fa-telegram\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_print\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on print\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<i class=\"fas fa-print\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Generic Name Doxorubicin Brand Name \u00aeAdriaCedal Drug Class Antineoplastic agent, Anthracycline Dosage Form Concentrate for Solution for Infusion 2 mg\/ml, 10 mg &#038; 50 mg Indications Contradications Warnings and Precautions Dosage and Administration Adverse Reactions Drug Interactions Use in pregnancy and lactation Storage Conditions Indications Acute leukaemia, Wilms&#8217; tumour, neuroblastoma, soft tissue and bone 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