Epirubicin
Cytostatic · Cytotoxic anthracycline antibiotic
Indications
Adjuvant therapy for primary breast cancer.
Dosage
Adults: IV: 100-120 mg/m² once weekly every 3-4 wk or 50-60 mg/m² days 1 and 8 every 3-4 wk Breast cancer: CEF-120: 60 mg/m² on days 1 and 8 for 8 cycles. FEC-100: 100 mg/m² on day 1 every 21 days 6 cycles.
Administration
Epirubicin should be administered into the tubing of a freely flowing IV infusion (0.9% NaCl or 5% glucose solution). The infusion time ranges between 3-20 min, depending on dosage and volume of the infusion solution. Avoid direct push injection. Flush well with a heparin-free solution before and after epirubicin administration. Compatibility: Stable in D5W, LR, NS; Incompatible with any solution of alkaline pH incompatible with heparin, fluorouracil. Stability: Store vials of injection solution in a refrigerator at 2°C-8°C (36°F-46°F). Do not freeze. Store vials of powder for solution at 25°C (77°F); excursions are permitted to 15°C-30°C (59°F-86°F). Protect from light. Discard unused portion. Store upright. Reconstituted solutions are stable for 24 hours when stored at 2°C-8°C (36°F-46°F) and protected from light, or 25°C (77°F) in normal lighting conditions. Epirubicin solution is…
Adverse Effects
Myelosuppression, cardiotoxicity, alopecia (reversible), GI disturbances, hyperpyrexia, fever, chills, urticaria, secondary acute myelogenous leukaemia, infection, blood dyscrasias, anorexia, dehydration, CHF, hot flush, GI upset, mucosal inflammation, skin and inf site reactions, red urine, amenorrhoea, malaise, abnormal transaminases, decreased LVEF, chemical cystitis after intravesical admin.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Intravesical use: UTI, bladder inflammation, haematuria, invasive tumours penetrating the bladder, catheterisation problems, large volume of residual urine, contracted bladder. IV use: persistent myelosuppression, severe hepatic impairment, severe myocardial insufficiency, recent MI, severe arrhythmias, previous treatment with max cumulative doses of epirubicin and/or other anthracyclines and anthraquinones, acute systemic infection, unstable angina, cardiomyopathy. Precautions: Monitor blood counts, renal and hepatic function. Risk of tumour-lysis syndrome; evaluate blood levels of uric acid, potassium, calcium phosphate and creatinine after initial treatment, minimize potential complications by ensuring hydration,…
Interactions
Interferon alfa-2b, dexrazoxane, calcium channel blockers, other cardiotoxic or myelosuppressive agents, live vaccines, cimetidine, paclitaxel, docetaxel, other cytotoxics, quinine.
Advice to Patient
This medication is administered by infusion. Inform prescriber immediately if there is burning/swelling/redness/irritation/pain at infusion site. Contact prescriber if there is difficulty in breathing, chest pain, palpitations, fast heartbeat, swelling of extremities, unusual cough, unrelieved nausea, vomiting, diarrhoea, fever, chills, change in urinary pattern, unusual bruising or bleeding, fatigue, skin rash, abdominal pain, unhealed mouth sores, purulent vaginal discharge, blood in stool or urine. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Using soft toothbrush, cotton swabs, regular mouth care may help to prevent mouth sores.
Pharmacokinetics
Absorption: Rapidly and extensively distributed into body tissues. Metabolism: Hepatic. Half-life elimination: Triphasic: Alpha: 3 mins. Beta: 2.5 hrs. Terminal (Gamma): 30-40 hrs. Excretion: Faeces (mainly). Urine (10%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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