Lifetime cumulative doses of anthracycline and related agents associated with cardiotoxicity in adults
Lifetime cumulative doses of anthracycline and related agents associated with cardiotoxicity in adults
Drug
Cumulative lifetime limit (mg/m2)
Daunorubicin[1]
400 to 550
Doxorubicin[2]
400 to 450
Epirubicin[3]
900
Idarubicin*[4,5]
150
Mitoxantrone[6]
140
Anthracycline cardiotoxicity is dose-dependent. If the cumulative lifetime dose exceeds the thresholds above, the risk of cardiotoxicity increases substantially. Patients and clinicians may choose to exceed the lifetime cumulative dose associated with cardiotoxicity in favor of the benefits of ongoing anthracycline treatment.
* For idarubicin, there is no consensus on threshold cumulative dose. Some guidelines suggest 150 mg/m2, but others disagree. Refer to UpToDate content on anthracycline cardiotoxicity for further details.