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Nudoxa is a non-pegylated liposomal formulation of doxorubicin hydrochloride, an anthracycline chemotherapy agent. Developed by Bharat Serums and Vaccines (part of the Bharat Daftary Group) in collaboration with Zydus, it is designed to optimize the therapeutic index of doxorubicin by altering its pharmacokinetic profile. The drug works by intercalating into DNA and inhibiting the enzyme DNA topoisomerase II, which leads to DNA strand breaks and prevents cancer cell replication. The liposomal delivery system, utilizing distearoyl-phosphatidylcholine, allows for prolonged circulation in the bloodstream and preferential accumulation in tumor tissues via the enhanced permeability and retention (EPR) effect. Unlike pegylated liposomal doxorubicin, this non-pegylated version is specifically designed to avoid the high incidence of palmar-plantar erythrodysesthesia (hand-foot syndrome), a common dose-limiting side effect of pegylated formulations. It is indicated for the treatment of various malignancies, including breast cancer, ovarian cancer, and AIDS-related Kaposi sarcoma.
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