pegylated liposomal DOXOrubicin

Hand-foot syndrome
(pain, thinning or reddening palms or feet, including tingling, numbness, peeling)

• Avoid activities that cause rubbing, pressure or heat exposure to hands and feet (i.e. gripping tools, vigorous washing, hot baths).
• Apply moisturizer liberally and often to your hands and feet, especially in the creases.
• Wear loose, comfortable footwear and clothes. Rest and try to keep off your feet.
• Also see Hand-Foot Syndrome pamphlet.*

Nausea and vomiting

• Drink clear fluids and avoid large meals. Get fresh air and rest.
• Limit spicy, fried foods or foods with a strong smell.
• Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
• Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
• Also see Nausea & Vomiting pamphlet.*

Mouth sores

• Maintain good mouth hygiene. Regular teeth brushing with a soft toothbrush or Toothette®, and regular use of alcohol-free mouthwashes.
• Instead, try a homemade mouthwash: 
  Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
• Avoid hot, spicy, acidic, hard or crunchy foods.
• Check with your doctor or nurse as soon as you notice sores in mouth/lips or pain with swallowing. Your doctor may prescribe a prescription mouthwash to relieve mouth sores and prevent infection.
• Also see Mouth Care pamphlet.*

Hair thinning or loss 

• Use a gentle soft brush; care should be taken with hair sprays, bleaches, dyes and perms.
• Your hair usually grows back after your treatment ends, but the texture or colour may change.

Tiredness

• Rest often; take naps if needed. Move slowly when getting up.
• Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
• Do not drive a motor vehicle or operate machinery when feeling tired.

Poor Appetite; don't feel like eating; weight loss

• Eat foods that you like and try to eat regular small meals.
• Use meal supplements if possible.  See a dietitian.

Rash (rarely severe); dry, itchy skin

• Stay out of the sun; wear sunblock, a hat and cover exposed skin.
• Use daily moisturizer.
• If severe, get emergency medical help right away.

Sensitivity reaction (usually the first injection only)
(flushing, rash, itchiness, facial swelling, headache, chest or throat tightness)

• Watch for symptoms during and shortly after the infusion

Allergic reaction is less common
(fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness)

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Heart problems
(irregular heartbeat, chest pain, fainting, swelling, shortness of breath)

Pain, burning, redness, or swelling on skin where drug was injected

• Let your healthcare team know right away when this happens, since this drug can harm or irritate tissues if it leaks from the vein during injection.