Epirubicin hydrochloride | Side Effects, Dosage, & More
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Generic Name:

epirubicin, Injectable solution

All Brands

  • Ellence
SECTION 1 of 5

Highlights for epirubicin

Injectable solution
1

Epirubicin is an injected drug used to treat breast cancer. It’s used with other chemotherapy drugs after surgery to keep your cancer from coming back.

2

It’s given as a solution infused into your vein. The medication is given to you by a doctor or nurse in their office or at a hospital. You won’t take this drug at home. Your dose will depend on how well you tolerate this medication and if you have liver or kidney disease.

3

This drug may cause serious heart problems, such as heart failure. This can be fatal. Heart problems may occur right away or years after you stop taking epirubicin. Your risk may be higher the longer you take the drug. Your doctor will do tests before starting and during treatment to check your heart function.

4

Epirubicin can cause severe nausea and vomiting. Your doctor may give you drugs before you receive this drug to help lower your risk.

5

Your urine may look red for 1–2 days after you receive epirubicin. This isn’t harmful.

6

The most common side effects include low blood cell counts, loss of menstrual periods, extreme tiredness, nausea, vomiting, diarrhea, infections, hair loss, and others. 

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Tissue damage warning. Epirubicin is a cancer drug that’s injected into a vein. If it leaks into surrounding tissue, it may cause severe damage and irritation. This can lead to symptoms like redness, swelling, sores, blisters, pain, and itching.

Heart damage warning. This drug may cause serious heart problems, such as heart failure. This can be fatal. Heart problems may occur right away or years after you stop taking epirubicin. Your risk may be higher the longer you take the drug. Your doctor will do tests before starting and during treatment to check your heart function.

Leukemia warning. Epirubicin may increase your risk for leukemia (white blood cell cancer). This occurs more often when the drug is given in high doses or with certain cancer drugs.

Liver problems warning. Epirubicin is cleared from your body by your liver. If you have liver problems, this drug may stay longer in your body and put you at risk for toxic effects. If you have liver disease, your doctor may give you a lower dose. People with severe liver disease shouldn’t use this drug.

Risk of severe bone marrow suppression. Epirubicin may cause a severe decrease in the production of blood cells (red blood cells, white blood cells, and platelets) in your bone marrow. This may increase your risk for anemia, a severe infection, or bleeding.

Tumor lysis syndrome

Epirubicin may increase the uric acid (hyperuricemia) in your blood due to the dying of cancer cells (tumor-lysis syndrome). Your doctor will do your blood tests and may give you other drugs or fluids to help prevent this.

Vaccines

Don’t receive live or live-attenuated vaccines while taking epirubicin. Examples of live vaccines include the live flu vaccine and measles, mumps, rubella vaccine. Receiving a live vaccine can cause a serious infection. This can be fatal. Talk to your doctor before receiving any vaccination while you’re on epirubicin.

Male fertility damage

If you’re a male with a female sexual partner on epirubicin, you should use effective birth control during and after your partner’s treatment with this drug. Epirubicin may damage sperm. This may cause a decrease in your fertility and increase the risk of genetic problems in the unborn child. How long this effect on sperm lasts is unknown.

What is epirubicin?

Epirubicin is a prescription drug. It’s available as an intravenous (IV) solution, which is only given by a healthcare provider.

This drug must be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Epirubicin is used to treat breast cancer. It’s used with other chemotherapy drugs after surgery to help keep your cancer from coming back.

How it works

Epirubicin belongs to a class of drugs called anthracyclines. A class of drugs refers to medications that work similarly.

More Details

How it works

Epirubicin belongs to a class of drugs called anthracyclines. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Cancer occurs when cells start growing out of control. Epirubicin blocks part of this cell cycle process. This prevents the cells from reproducing and growing. It also kills existing cancer cells.

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SECTION 2 of 5

epirubicin Side Effects

Injectable solution

Most Common Side Effects

The most common side effects that occur with epirubicin include:

  • low white blood cell count. This could lead to infections.

  • low red blood cell count (anemia)

  • low platelets count. This can keep your blood from clotting.

  • loss of menstrual periods (amenorrhea)

  • extreme fatigue

  • nausea or vomiting

  • swelling of the tissue inside of your mouth (mucositis)

  • diarrhea

  • infections

  • hair loss (alopecia)

  • skin rash and itching

  • swelling of the cornea of your eye (keratitis) or the membrane that lines your eye (conjunctiva)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • tissue damage (necrosis). If epirubicin leaks into surrounding tissue, it may cause severe damage and irritation. Symptoms in the place where the drug was injected include:

    • redness
    • swelling
    • sores
    • blisters
    • pain
    • itching
  • heart damage. Symptoms include:

    • swelling of your hands, feet, ankles, or lower legs
    • shortness of breath
    • trouble breathing
    • fast or irregular heart rate
    • fullness or swelling of your stomach
  • leukemia (white blood cell cancer). Symptoms include:

    • bone pain
    • fatigue
    • anemia. Symptoms include:
      • fast heart rate
      • chest pain
      • trouble breathing when exerting yourself
      • lightheadedness or dizziness
    • low white blood cells (infection). Symptoms include:
      • fever of 100.5°F or higher taken by mouth
      • chills or sweats
      • sore throat
      • nasal congestion
      • cough
      • sinus pain
      • white coating or sores in your mouth
      • pain or burning when urinating
      • stomach pain
      • redness or swelling anywhere or at sites of wounds/injuries
  • liver problems. Symptoms include:

    • swelling and pain in your stomach
    • swelling in your ankles and legs
    • yellowing of your skin or the whites of your eyes (jaundice)
    • itchy skin
    • pale or bloody, tar-colored stool
    • dark-colored urine
    • nausea
    • vomiting
    • loss of appetite
    • tiredness
    • bruising easily
  • severe bone marrow suppression. This may increase your risk for anemia, a severe infection, or bleeding. Symptoms include:

    • low red blood cells (anemia). Symptoms include:
      • fast heart rate
      • chest pain
      • trouble breathing when exerting yourself
      • lightheadedness or dizziness
    • low white blood cells (infection). Symptoms include:
      • fever of 100.5°F or higher taken by mouth
      • chills or sweats
      • sore throat
      • nasal congestion
      • cough
      • sinus pain
      • white coating or sores in your mouth
      • pain or burning when urinating
      • stomach pain
      • redness or swelling anywhere or at sites of wounds/injuries
    • low platelets (bleeding). Symptoms include:
      • pin-sized red or purple spots on your skin (petechiae)
      • unusual bleeding from cuts that takes longer to stop
      • blood in your urine
      • blood in your stool or black, tarry stools
      • unusually heavy menstrual periods
      • unusual bruising
      • bleeding from your gums or nose
    • blood clots in your legs or lungs. Symptoms include:
      • warmth, redness, or swelling of your leg
      • shortness of breath
      • chest pain when breathing
      • coughing up blood
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Epirubicin doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

epirubicin May Interact with Other Medications

Injectable solution

Epirubicin can interact with other medications, herbs, or vitamins you might be taking. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs or vitamins you’re taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Epirubicin warnings
heart disease
People with heart disease

Epirubicin may decrease your heart’s ability to pump blood. This may cause serious heart problems, such as heart failure. If you currently have or have a history of heart disease, this drug may increase your risk of more heart issues.

liver disease
People with liver disease

Epirubicin is cleared from your body by your liver. If you have liver problems, this drug may stay longer in your body and put you at risk for side effects. Your doctor may do tests before starting and during treatment with epirubicin to check your liver function. You may need a lower dose of this drug. Or if you have severe liver disease, you may not be able to take this drug at all.

kidney disease
People with kidney disease

Your doctor may check how well your kidneys are working before and during treatment with epirubicin. Your dose may need to be adjusted based on your kidney function. You may be exposed to higher levels, especially if you’re on dialysis.

radiation
People who have received radiation

If you’ve previously received radiation and then take epirubicin, you may have an inflammatory reaction at the site where you received irradiation.

pregnant women
Pregnant women

Epirubicin is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breastfeeding
Women who are breast-feeding

It isn’t known if epirubicin passes into breast milk. If it does, it may cause serious effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take epirubicin or breastfeed.

for seniors
For seniors

If you’re at least 70 years of age, your doctor should monitor you more closely while you take this drug. Your body may not be able to clear out the drug as well or as quickly as it should. This raises your risk for toxic side effects.

for children
For children

The safety and effectiveness of epirubicin in people younger than 18 years haven’t been established. Children who take this drug may have a higher risk for acute heart damage (cardiotoxicity) and chronic congestive heart failure.

allergies
Allergies

Epirubicin can cause a severe allergic reaction. Symptoms include:

  • skin rash
  • itching
  • fever
  • chills
  • shock

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take epirubicin (Dosage)

Injectable solution

Your doctor will determine a dose that’s right for you based on your individual needs. Your general health may affect your dose. Tell your doctor about all health conditions you have before your doctor or nurse administers the drug to you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Epirubicin comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all, stop taking it, or don’t take it schedule

If you don’t get your epirubicin infusion, you may have a higher risk of your breast cancer coming back. In breast cancer, the cancer cells may break away from the main tumor and spread to other parts of the body (known as metastasis). Epirubicin is used in combination with other chemotherapy drugs to kill any cancer cells that may have spread to other parts of your body. This helps to prevent the cancer from reoccurring.

If you skip or miss doses or appointments

If you miss a dose or appointment, you should call your doctor right away to find out what to do.

If you take too much

It isn’t fully understood what happens if you take too much epirubicin. You may have a higher risk of the following conditions:

  • extremely severe bone marrow suppression
  • swelling of the tissue inside of your mouth or throat (mucositis)
  • stomach or intestinal bleeding
  • multiple organ failure

An overdose may even be fatal. If you have an overdose, your doctor will treat the symptoms you have until you recover.

  • swelling of the tissue inside of your mouth or throat
  • stomach or intestinal bleeding
  • lung failure
  • kidney failure
  • weakness
  • extremely severe bone marrow suppression
  • extremely elevated body temperature
  • death

How to tell if the drug Is working

Your doctor will let you know if epirubicin is working by doing tests to check if your breast cancer has come back.

Epirubicin is used as short-term treatment.

This medication is given in 3-week to 4-week cycles

Your total dose is either given on day 1 of each cycle or dived equally and given on days 1 and 8 of each cycle.

How long does it take?

It takes about 15–20 minutes to receive epirubicin. Your appointment may take more time, though. Allow extra time for your healthcare provider to receive your lab test results and to prepare your dose before your infusion. They may also have you stay after your infusion to monitor you for side effects.

Can I drive home after?

You may need a ride home after receiving epirubicin.

Travel

Talk to your doctor before you plan your travel.

You may need to schedule your travel around your epirubicin schedule.

Epirubicin should only be given by a healthcare professional who’s familiar with your medical history, experienced with chemotherapy, and at a location with appropriate medical support to manage severe infusion reactions such as necrosis.

Clinical monitoring

Your doctor will monitor your treatment. During treatment with this drug, your doctor will check for:

  • tissue damage (necrosis). If epirubicin leaks into surrounding tissue, it may cause severe damage and irritation. Your doctor will check you for reactions at the site where the drug is being injected. Symptoms include:
    • redness
    • swelling
    • sores
    • blisters
    • pain
    • itching
  • complete blood cell count
  • kidney function tests
  • liver function tests
  • heart function tests to check how well your heart is pumping blood
  • tests to check your electrolytes levels
  • blood tests to make sure you’re not experiencing tumor lysis syndrome. Your doctor will check your levels of:
    • uric acid
    • potassium
    • calcium
    • phosphate
    • creatinine

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for epirubicin.

SECTION 5 of 5

How Much Does epirubicin Cost?

Injectable solution

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These prices represent the lowest priced national pharmacies for epirubicin on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 13, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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