EPIRUBICIN

Background and Date of Approval

Epirubicin is an antineoplastic drug that belongs to the class anthracyclines. FDA approved epirubicin on November 15, 2006, for the treatment of breast cancer, stomach, and bowel cancer, ovarian cancer, and lung cancer.

Uses

Epirubicin is an intravenously administered drug. This medicine is used as adjuvant therapy in combination with other medications to treat breast cancer in patients who have had surgery to remove the tumor. It is also useful in treating breast, ovaries, stomach, bowel, and lung cancers. In addition, this medicine is also used to treat cancers of the blood-forming tissues, such as malignant lymphomas, leukemias, and multiple myeloma.

How is it administered?

The drug should be administered only by healthcare professionals experienced with cancer chemotherapy. Your physician will determine the dose and frequency of administration based on the type of cancer and severity of the disease. The medicine will be given as an infusion into a vein. Do not self-administer the injection.

Side Effects

Epirubicin side effects include hair loss, flushing, rash, itching, diarrhea, nausea and vomiting, anemia, decreased WBC and platelets, eye infection, and irregular menstruation. Other serious side effects include congestive heart failure, increased blood urea levels, severe hypersensitivity reactions, and lung problems.

Warnings

This drug is intended to cause liver problems. Monitor liver function test regularly before and during the treatment. Long-term use of this medicine may cause tumor lysis syndrome, regular monitoring of blood uric acid levels, potassium, calcium, and creatinine levels after initial treatment is necessary. This medicine may cause severe fetal harm if taken during pregnancy. Inform your doctor if you are pregnant or planning for pregnancy before initiating the treatment.

Precautions

This medicine may cause infertility in men and women; inform your physician if you are planning for pregnancy. If you are sexually active, you are advised to use effective birth control to prevent pregnancy. Before initiating the treatment, inform your physician if you have kidney or liver problems, recent vaccination, or if you have any acute toxicities such as acute inflammation of the mouth, low white blood cell count, platelet count, or any infections. This medicine may increase your risk of blood clots. Your healthcare professional may advise you to take certain blood tests to monitor the effectiveness and side effects of the therapy.

Word of Advice

Do not take this injection if you are allergic to Epirubicin or any other ingredients of this medicine, pregnant or breastfeeding, or have severe liver and bladder problems.Store Epirubicin in the refrigerator (2°C to 8°C). Do not freeze. Keep the injection away from the reach of children and pets. If you have missed any dosing appointments, inform your doctor and schedule immediately. Inform your physician if you are receiving radiation therapy with this medicine. Male patients with female partners of reproductive potential should use effective birth control during the treatment and for 3 months after the last dose. Do not breastfeed during the treatment and for 7 days after the last dose. The medicine may turn your urine red for 1 or 2 days after your treatment.

References

Epirubicin hydrochloride 2 mg/ml solution for injection - Summary of Product Characteristics (SmPC) - (emc). Medicines.org.uk. [revised on 2016] [cited 2023 Mar 31]. Available from: https://www.medicines.org.uk/emc/product/6361/smpc HIGHLIGHTS OF PRESCRIBING INFORMATION - Epirubicin. [revised on 2019] [cited 2023 Mar 31]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/050778s024s025lbl.pdf KD Tripathi, Essentials of Medical Pharmacology, Anticancer drugs, 7th edition, 2013, 867.

Frequently Asked Questions

How long should I have to take epirubicin?

Epirubicin is given as a cycle therapy. Your doctor will decide the dose and duration of the therapy based on your disease severity and condition.

What if epirubicin does not work for me?

There are alternative medicines that may work for you based on your disease condition and other factors. Your doctor will decide the alternative treatment tha works best for you.

What are the precautions of epirubicin?

This medicine may increase your risk of developing blood clots. If you have chest pain, trouble breathing, or pain, redness, or swelling in your arms or legs while using this medicine, call your doctor immediately. This medicine may turn your urine red for 1 or 2 days after your treatment.

Is there any special diet that I should follow while taking Epirubicin?

There are no special restrictions on the diet. If your doctor or any other healthcare professional tells you to avoid certain food, then avoid it. Diet restrictions may vary from patient to patient. Consult your doctor for more advice.

Does epirubicin cause infertility?

Yes, epirubicin causes infertility in men and women. Talk to your doctor if you are suspecting or planning for pregnancy.

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Written By: P. Thirumal Reddy

Reviewed By: Dr. Tejashwin Adiga