Mechanism of Action of Epirubicin
Indications of Epirubicin
- For use as a component of adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer.
- Ellence Injection is indicated as a component of adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer. /Included in US product labeling/
- Antibiotics, Antineoplastic; Topoisomerase II Inhibitors
Contra-Indications of Epirubicin
- Severe infection
- Severely Decreased Activity of the Bone Marrow
- Anemia
- Decreased Blood Platelets
- Decreased Neutrophils a Type of White Blood Cell
- Heart attack
- Heart attack within the last 30 days
- Disease of the Muscle of the Heart with Enlargement
- Abnormal heart rhythm
- Life-Threatening Irregular Heart Rhythm
- Chronic heart failure
- Suddenly serious symptoms of heart failure
- Painful
- Red or Swollen Mouth
- Severe liver disease
- Severe renal impairment
- High Amount of Bilirubin in the Blood
- Pregnancy
- A mother who is producing milk and breastfeeding
- Allergies to Anthracyclines
Dosage of Epirubicin
Strengths: 2 mg/mL; 50 mg; 200 mg
Breast Cancer – Adjuvant
For use as a component of adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer
- Starting Dose: 100 to 120 mg/m2 by intravenous infusion every 3 to 4 weeks. The total dose may either be given on Day 1 of each cycle or divided equally and given on Days 1 and 8 of each cycle.
Side Effects of Epirubicin
Most Common
- Pain, redness, swelling at the place of injection
- Painful swallowing
- Signs of anemia (e.g., feeling weak, dizzy, or short of breath)
- Signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, cuts that don’t stop bleeding)
- Signs of a blood clot in blood vessels, such as sudden vision change or dizziness, chest pain, pain and swelling in one leg muscle
- Signs of an infection (e.g., fever over 38°C, chills or sweating, sore throat, coughing, redness or swelling around a cut, wound or catheter site, painful or difficult urination, unusual vaginal itching or discharge)
More Common
- Hair loss, thinning of hair
- Nausea and vomiting
- Sores in the mouth and on the lips
- Darkening of the soles, palms, or nails
- Diarrhea
- Fast or irregular heartbeat
- Shortness of breath
- Swelling of the feet and lower legs
Less Common
- Cough or hoarseness accompanied by fever or chills
- Darkening or redness of the skin (if you recently had radiation treatment)
- Fast or irregular heartbeat
- Fever or chills
- Joint pain
- Lower back or side pain accompanied by fever or chills
- Pain at the injection site
- Painful or difficult urination accompanied by fever or chills
- Red streaks along the injected vein
Drug Interactions of Epirubicin
Epirubicin may interact with following drugs, supplements & may change the efficacy of drugs
- antipsychotics (e.g., chlorpromazine, clozapine)
- atorvastatin
- “azole” antifungals (e.g., fluconazole, itraconazole, voriconazole)
- bevacizumab
- azathioprine
- bevacizumab
- cimetidine
- cyclophosphamide
- daunorubicin
- doxorubicin
- mercaptopurine
- bupropion
- calcium channel blockers (e.g., diltiazem, verapamil)
- carbamazepine
- carvedilol
- celecoxib
- ciprofloxacin
- cyclosporine
- dasatinib
- desipramine
- dexamethasone
- hydrocortisone
- loperamide
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- mercaptopurine
- metronidazole
- non-drowsy” antihistamines (e.g., cetirizine, desloratadine, loratadine)
- norfloxacin
- other anthracyclinecancer medications (e.g., daunorubicin, idarubicin)
- other cancer medications (e.g., cyclophosphamide, doxetaxel, irinotecan, paclitaxel)
- oxcarbazepine
- pentobarbital
- phenobarbital
- phenytoin
- prazosin
- progesterone
- propranolol
- protease inhibitors (e.g., lopinavir, ritonavir, stavudine)
- selegiline
- SSRI antidepressants (e.g., fluoxetine, paroxetine, sertraline)
- St. John’s wort
- tacrolimus
- tamoxifen
- tetracycline
Pregnancy Category
FDA Pregnancy Category: D
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Lactation
This medication passes into breast milk. If you are a breastfeeding mother and are taking doxorubicin, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding. Children who receive doxorubicin are at an increased risk of developing leukemia. Children may also be more susceptible to the effects of this medication on the heart.
References
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