Doxorubicin: veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Adriamycin, Adriablastina, Doxorubicin HCl

Species with doses

Dogs, Cats, Horses and Ferrets

Routes

IV

Last reviewed

1 October 2026

Indications

• Lymphoma / lymphoid leukaemia (CHOP and single-agent doxorubicin protocols)
• Haemangiosarcoma (adjuvant/with other agents)
• Osteosarcoma (adjuvant with carboplatin)
• Various carcinomas and soft-tissue sarcomas (per protocol)

Doxorubicin dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Lymphoma / neoplasia (BSA dosing): Dosed by BODY SURFACE AREA (NOT mg/kg). Papich 5e: 30 mg/m² IV every 21 days; dogs >15 kg 30 mg/m², <15 kg 1 mg/kg. Plumb’s p.447: 30 mg/m² IV every 2–3 weeks; maximum cumulative dose 240 mg/m² (cardiotoxicity). Echocardiography before and during treatment; CBC before each dose. Vesicant — perfect IV technique. Consult an oncologist.

Cats

• Lymphoma / neoplasia (BSA dosing): Papich 5e: 20 mg/m² (≈1.25 mg/kg) IV every 3 weeks; 25 mg/m² appears equally tolerated. Plumb’s p.447: 20–30 mg/m² IV every 2–4 weeks; maximum cumulative dose usually 240 mg/m². Nephrotoxicity is dose-limiting in cats — monitor renal values.

Horses

• Neoplasia (per protocol): Papich 5e. Consult an oncologist.

Ferrets

• Neoplasia (per protocol): Plumb’s p.447. Consult an oncologist.

Contraindications

Pre-existing cardiac disease / reaching the cumulative cardiotoxic dose ceiling. Significant myelosuppression. Cats with renal impairment (nephrotoxicity). Perivascular administration (vesicant — necrosis). Pregnancy. Known hypersensitivity (anaphylactoid — premedicate/slow infusion). Hepatic impairment (reduce dose — hepatic clearance).

Species-specific warnings

Cats: Nephrotoxicity is the dose-limiting toxicity in cats — monitor renal function; cumulative cardiotoxicity is less prominent than in dogs.

Dogs: Cumulative dose-dependent cardiotoxicity (dilated cardiomyopathy) — echocardiographic monitoring and a cumulative-dose ceiling are essential; certain breeds (e.g. Dobermanns) are more susceptible.

Adverse effects

• CUMULATIVE cardiotoxicity (arrhythmias acutely; dilated-cardiomyopathy/CHF chronically — often irreversible)
• Myelosuppression (neutrophil nadir ~7–10 days)
• GI: vomiting, diarrhoea, anorexia (delayed colitis in dogs)
• Severe tissue necrosis if EXTRAVASATED (vesicant)
• Anaphylactoid infusion reactions; nephrotoxicity (cats); red urine (harmless); alopecia

Drug interactions

• Other cardiotoxic drugs / prior chest radiation: additive cardiotoxicity
• Other myelosuppressive chemo: additive marrow suppression (built into protocols)
• Cyclophosphamide/vincristine/prednisolone: combined in CHOP
• Dexrazoxane: a cardioprotectant/extravasation antidote used with doxorubicin

Pregnancy and lactation

Contraindicated in pregnancy (teratogenic/cytotoxic). Handle with full cytotoxic precautions; pregnant staff must not handle/administer.

Monitoring

• CARDIAC function — echocardiography before starting and periodically; track CUMULATIVE dose toward the ceiling
• CBC before each dose (neutrophil nadir ~7–10 days)
• IV catheter placement/patency (vesicant) and the site during/after infusion
• Renal values (especially cats); GI signs; anaphylactoid-reaction surveillance during infusion

Toxicity and overdose

Defining toxicities: cumulative, often IRREVERSIBLE cardiotoxicity (acute arrhythmias; chronic dilated cardiomyopathy/CHF — hence the cumulative-dose ceiling and echocardiographic monitoring), myelosuppression, GI toxicity (incl. delayed haemorrhagic colitis in dogs), anaphylactoid infusion reactions, and — in cats — nephrotoxicity. EXTRAVASATION causes progressive, severe tissue necrosis. Overdose intensifies all of these.

Management: No simple antidote. DEXRAZOXANE is used both as a cardioprotectant and as the antidote for doxorubicin EXTRAVASATION (give IV within hours; also stop, aspirate, apply COLD compresses — opposite to vinca extravasation). Manage neutropenic sepsis (antibiotics ± G-CSF), GI toxicity, and cardiac failure supportively; treat anaphylactoid reactions (slow/stop infusion, antihistamine/steroid). Monitor cardiac function and CBC.

Clinical pearls

• Dose by BODY SURFACE AREA (mg/m²) and TRACK the CUMULATIVE dose — cardiotoxicity is cumulative and often irreversible (echo before and during therapy; respect the ~180–240 mg/m² canine ceiling)
• A potent VESICANT — a flawless single-stick IV is essential; for extravasation, use COLD compresses and dexrazoxane (the opposite approach to vincristine)
• The backbone anthracycline of lymphoma (CHOP) and many solid-tumour protocols; check the CBC before every dose
• In CATS, nephrotoxicity (not cardiotoxicity) is dose-limiting — monitor renal values; handle with full cytotoxic precautions

Mechanism of action

An anthracycline that (1) intercalates into DNA and inhibits TOPOISOMERASE II, causing DNA strand breaks and blocking replication/transcription, and (2) generates free radicals (reactive oxygen species) that damage DNA and membranes — cytotoxic to rapidly dividing cells (cell-cycle non-specific). The free-radical generation, to which cardiac muscle is especially vulnerable (low antioxidant capacity), underlies the characteristic cumulative cardiotoxicity; the same reactive metabolites cause the severe tissue necrosis on extravasation.

Formulations and products

• Injection 2 mg/mL (10 / 50 mg vial)
• Liposomal doxorubicin (Doxil) — reduced cardiotoxicity
• Adriamycin / Doxorubicin — 2 mg/mL (10 / 50 mg vial), Injection (human-label)
• Doxil (liposomal) — 2 mg/mL liposomal, Injection (reduced cardiotoxicity) (human-label)

Storage

Injection: REFRIGERATE (2–8 °C), protect from light. Handle as a hazardous cytotoxic (closed-system/PPE); dispose appropriately. Reconstituted/diluted per protocol.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Dimercaprol (BAL)
• Dinoprost (PGF2α)
• Diphenhydramine
• Doxapram
• Enoxaparin
• Epinephrine
• Erythropoietin (Epoetin / Darbepoetin)
• Estriol

Frequently asked questions