of Drugs: Anthracycline/Antineoplastic
Pharmacia & Upjohn
on Patient Assistance program: Prescription
Medication Assistance Program, Self-Administered products: (800)
242-7014; Non Self-Administered products: (800) 366-5570
Epirubicin is intended for intravenous
administration. If epirubicin accidentally leaks out of the vein
into which it is injected, it may damage some tissues and cause
scarring. Tell the doctor or nurse right away if you notice redness,
pain, or swelling at the place of injection .
Epirubicin is the 4'-epimer of
It has been widely used as adjuvant
therapy for early breast cancer and in metastatic breast cancer.
Recently, the US Food and Drug Administration (FDA) approved epirubicin
for use as a component of adjuvant therapy in women with early stage,
node-positive breast cancer.
antineoplastic effect of epirubicin are that it inhibits DNA, RNA,
and protein synthesis, it produces cytocidal activity and it interferes
with replication and transcription.
taking epirubicin it is especially important that you inform your
health care professional know if you are taking any of the following:
use of these agents with epirubicin may increase risk of liver
Acetaminophen (e.g., Tylenol) (with long-term, high-dose use); Amiodarone
(e.g., Cordarone); Anabolic steroids, nandrolone [e.g., Anabolin],
oxandrolone [e.g., Anawar], oxymetholone [e.g., Anadrol], stanozolol
[e.g., Winstrol]); Androgens (male hormones); Carmustine (e.g.,
BiCNU); Chloroquine (e.g., Aralen); Dantrolene (e.g., Dantrium);
Disulfiram (e.g., Antabuse); Divalproex (e.g., Depakote); Estrogens
(female hormones); Etretinate (e.g., Tegison); Hydroxychloroquine
(e.g., Plaquenil); Methyldopa (e.g., Aldomet); Maltrexone (e.g.,
Trexan) (with long-term, high-dose use); Oral contraceptives (birth
control pills) containing estrogen; Phenothiazines (acetophenazine
[e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g.,
Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon],
prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine
[e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine
[e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine
[e.g., Temaril]); Phenytoin (e.g., Dilantin); Valproic acid (e.g.,
use of these agents with epirubicin may cause blood disorders:
Acyclovir (e.g., Zovirax); Anticonvulsants (seizure medicine); Antidiabetics,
oral (diabetes medicine taken by mouth); Antipsychotics (medicine
for mental illness); Captopril (e.g., Capoten); Enalapril (e.g.,
Vasotec); Flecainide (e.g., Tambocor); Imipenem; Inflammation or
pain medicine, except narcotics; Lisinopril (e.g., Prinivil, Zestril);
Maprotiline (e.g., Ludiomil); Penicillamine (e.g., Cuprimine); Pimozide
(e.g., Orap); Procainamide (e.g., Pronestyl); Promethazine (e.g.,
Phenergan); Ramipril (e.g., Altace); Sulfasalazine (e.g., Azulfidine);
Tiopronin (e.g., Thiola); Tocainide (e.g., Tonocard); Tricyclic
antidepressants (medicine for depression); Trimeprazine (e.g., Temaril).
use of these agents with epirubicin increases the risk of infection:
Amphotericin B, injection (e.g., Fungizone); Antineoplastics, other
(cancer medicine); Azathioprine (e.g., Imuran); Chloramphenicol
(e.g., Chloromycetin); Colchicine; Cyclophosphamide (e.g. Cytoxan);
Flucytosine (e.g. Ancoban);
Ganciclovir (e.g., Cytovene); Interferon (e.g., Intron A, Roferon-A);
Zidovudine (e.g., AZT, Retrovir).
use with epirubicin may cause blood disorders and increase
risk of liver problems:
Anti-infectives, by mouth or injection (medicine for infection);
Carbamazepine (e.g., Tegretol); Gold salts (medicine for arthritis).
use with epirubicin increases the risk of infection and may
increase the risk of liver problems:
Antithyroid agents (medicine for overactive thyroid); Mercaptopurine
(e.g., Purinethol); Methotrexate (e.g., Rheumatrex);
Plicamycin (e.g., Mithracin).
use of these agents with epirubicin may contribute to heart damage
Bepridil (e.g., Vascor); Diltiazem (e.g., Cardizem); Flunarizine
(e.g., Sibelium); Isradipine (e.g., DynaCirc); Nicardipine (e.g.,
Cardene); Nifedipine (e.g., Procardia); Nimodipine (e.g., Nimotop);
Verapamil (e.g., Calan); other heart medicines.
use of maximum cumulative doses of other anthracyclines with epirubicin
may increase risk of heart damage, secondary leukemia,
and stomach and blood problems.
use may increase risk of liver problems.
Cimetidine (e.g., Tagamet)--Cimetidine increases the amount of time
epirubicin stays in the body.
Daunorubicin (e.g., Cerubidine); Doxorubicin (e.g., Adriamycin);
Idarubicin (e.g., Idamycin); Mitoxantrone (e.g., Novantrone).
you have ever been treated with radiation or cancer medicines --
Epirubicin may increase the effects of these medicines or radiation
therapy on the blood
you have ever been treated with radiation to your chest -- Risk
of heart problems caused by epirubicin may be increased
may cause fetal harm when administered to a pregnant woman.
is increased risk of a second leukemia associated with the
use of this drug.
major adverse effects of epirubicin are acute dose-limiting haematological
toxicity and cumulative dose-related cardiac toxicity. These effects
are less severe after epirubicin administration than after equimolar
doses of doxorubicin.
initiating therapy with epirubicin, you should be informed that
there is a risk of irreversible damage to the heart muscle associated
with the drug. For women who receive epirubicin as adjuvant therapy,
there is a slightly increased risk of treatment-related leukemia.
Epirubicin may cause harm to the fetus if you are pregnant when
taking it. The drug may also cause premature menopause. Men undergoing
treatment with epirubicin should be advised to use effective contraceptive
methods because therapy with the drug can induce chromosomal damage
adverse effects associated with the use of this drug include nausea,
vomiting, diarrhea, stomatitis and hair loss.
with your doctor or nurse immediately if any of the following side
effects occur: bleeding, redness, or ulcers in mouth or throat;
cough or hoarseness; fever or chills; lower back or side pain; painful
or difficult urination; pain or burning in mouth or throat; sores
in mouth or on lips; black, tarry stools; blood in urine or stools;
pinpoint red spots on skin; redness or discharge of the eye, eyelid,
or lining of the eyelid; red streaks along injected vein; unusual
bleeding or bruising; darkening or redness of skin at place of irradiation;
fast or irregular heartbeat; joint pain; pain, redness, or warmth
at place of injection; skin rash or itching; swelling of abdomen,
lower legs, and feet; swelling or tenderness of lymph nodes, abdomen,
side or lower back; wheezing, difficulty breathing or shortness
dosage of this drug is very specific. If you notice abdominal swelling
or tenderness, black stools, blood in your stools, if you have difficulty
in urination, fast or irregular heartbeat, high fever, shortness
of breath, stomach pain, swelling of the lining of your mouth, nose
or throat or severe vomiting these may be signs of an overdose and
you should contact your doctor immediately.
side that effects may appear and then diminish during the treatment
are lack of menstrual periods, nausea and vomiting; diarrhea, hot
flashes, darkening of soles, palms, or nails and loss of appetite
or weight loss.
you stop receiving epirubicin, you may notice some side effects
that need attention. Check with your health care professional
immediately if you notice fast or irregular heartbeat, shortness
of breath or swelling of abdomen, feet, and lower legs.
side effects not listed above may also occur in some patients. If
you notice any other effects, check with your doctor.
causes the urine to turn reddish in color, which may stain clothes.
This is not blood. It should only lasts for 1 or 2 days after each
dose is given.
drug may cause a temporary and total loss of all body hair (reversible
alopecia). After your treatment has ended, normal hair growth should
to Drug Index
information is intended as reference and not as medical advice.
All treatment decisions should be made with your team of medical
professionals and prescriptions must be given by your doctor.