Epirubicin injection

What is epirubicin injection?

EPIRUBICIN (Ellence®) is a type of cancer chemotherapy used for treating many kinds of cancer including bone, breast, stomach, lung, and ovarian cancer. Epirubicin interferes with the growth of rapidly growing cells, like cancer cells, and eventually causes cell death. Epirubicin is used alone or in combination with other cancer chemotherapy agents. Generic epirubicin injections are not available.

What should my health care professional know before I receive epirubicin?

They need to know if you have any of these conditions:

• angina

• bleeding problems

• blood disorders

• hypertension

• heart disease, including a history of a heart attack

• infection (bacterial, viral or fungal)

• irregular heart beat

• kidney disease

• liver disease

• previous chemotherapy with daunorubicin, doxorubicin, idarubicin, or mitoxantrone

• previous radiation therapy

• an unusual or allergic reaction to epirubicin, other chemotherapy agents, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Epirubicin is for infusion into a vein. It is usually given in a hospital or clinic setting by a trained health-care professional. If you notice pain, swelling, burning or any unusual feelings around the site of your injection, tell your health care professional immediately. There may be several weeks between doses.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

It is important not to miss a dose. Let your prescriber or health care professional know if you are unable to keep an appointment.

What drug(s) may interact with epirubicin?

Ask your prescriber or health care professional about other medicines that may increase the effect of epirubicin.

• certain antibiotics (clarithromycin, erythromycin, gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, sparfloxacin)

• cimetidine

• cisapride

• chloroquine

• dolasetron

• droperidol

• foscarnet

• levomethadyl

• medicines used to control the heart rhythm (examples: amiodarone, bepridil, disopyramide, flecainide, probucol, procainamide, propafenone, quinidine, sotalol)

• medicines used for mental problems, psychosis, or depression (examples: amitriptyline, chlorpromazine, fluphenazine, haloperidol, mesoridazine, perfenazine, pimozide, prochlorperzine, risperidone, thioridazine, ziprasidone)

• methadone

• other chemotherapy agents may increase the side effects seen with epirubicin

• palonosetron

• pentamidine

• prochlorperazine

• vaccines

Talk to your prescriber or health care professional before taking any of these medicines:

• aspirin

• acetaminophen

• ibuprofen

• naproxen

• ketoprofen

Tell your prescriber or health care professional about all other medicines that you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also, tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking epirubicin?

Visit your prescriber or health care professional for regular checks on your progress. You will need to have regular blood checks.

Epirubicin may cause permanent damage to your heart. Your prescriber will monitor the function of your heart to make sure this does not happen. Epirubicin may also cause other types of cancer (leukemia). The risk of this occurring is very small. Ask your prescriber or health care professional if you have any questions about these effects.

After treatment with epirubicin your urine may be a red color. This is different from blood in the urine and will disappear within a few days, with no cause for alarm. If you think you may have blood in the urine call your prescriber or health care professional for advice.

Epirubicin may make you feel generally unwell. This is not uncommon because epirubicin affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Epirubicin will decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Epirubicin may increase your risk to bruise or bleed. Call your prescriber or health care professional if you notice any unusual bleeding. Be careful not to cut, bruise or injure yourself because you may get an infection and bleed more than usual.

Avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), ketoprofen (Orudis® KT), or naproxen (Aleve®) products as these may mask a fever, unless instructed to by your prescriber or health care professional.

Call your prescriber or health care professional if you get diarrhea. Do not treat yourself. Some diarrhea medicine will make the diarrhea worse.

Be careful brushing and flossing your teeth or using a toothpick while receiving epirubicin because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you have received epirubicin.

Men and women of childbearing age should use effective birth control methods during epirubicin treatment. There is a risk of birth defects if a woman becomes pregnant and is being treated with epirubicin. Women should not become pregnant while being treated with epirubicin or if their partner is being treated with epirubicin.

Caregivers of patients receiving epirubicin should take care to prevent contact with the patient's urine and other body fluids by wearing latex gloves for at least 5 days after each treatment.

What side effects may I notice from receiving epirubicin?

The side effects you may experience with epirubicin therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:

Rare or uncommon:

• chest pain

• difficulty breathing, wheezing

• irregular heart beat

• swelling of ankles or feet

Common:

• low blood counts - epirubicin may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine

• signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness

• mouth or throat sores or ulcers

• pain, redness, swelling or irritation at the injection site

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• changes in skin or nail color

• diarrhea

• facial flushing

• hair loss

• heartburn

• increased skin sensitivity to the sun

• loss of appetite

• nausea, vomiting

• red color in urine (may appear for 1 to 2 days after treatment)

Where can I keep my medicine?

This medicine is given through your vein at a clinic or hospital. You will not have to take this medicine at home.