Generic Name: valrubicin (val ROO bi sin)
Brand Name: Valstar
What is valrubicin?
Valrubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body.
Valrubicin is used to treat bladder cancer that has not spread to other parts of the body.
Valrubicin is usually given after BCG (Bacillus Calmette and Guérin) has been tried without success.
Valrubicin may also be used for purposes not listed in this medication guide.
What is the most important information I should know about valrubicin?
You should not use valrubicin if you have a urinary tract infection, bladder perforation (a hole or tear), overactive bladder, incontinence, or trouble holding in urine.
What should I discuss with my health care provider before I receive valrubicin?
You should not use valrubicin if you are allergic to it, or if you have:
a urinary tract infection;
bladder perforation (a hole or tear); or
a history of allergic reaction to cancer medicines such as daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone.
To make sure valrubicin is safe for you, tell your doctor if you have:
overactive bladder, incontinence or leakage;
trouble holding a large amount of urine in your bladder; or
if you have recently had bladder surgery.
Most people who receive valrubicin do not have a complete response to this medication. You may eventually need to have your bladder removed to prevent your cancer from spreading to other parts of your body.
Use effective birth control to avoid pregnancy during your treatment with valrubicin, whether you are a man or a woman. Follow your doctor's instructions about how long to prevent pregnancy after your treatment ends.
FDA pregnancy category C. It is not known whether valrubicin will harm an unborn baby if the medicine remains only in the bladder. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
It is possible that valrubicin could leak internally from the bladder and spread to other organs, including the uterus. If this happens during pregnancy, this medicine could harm the unborn baby or cause a miscarriage or stillbirth. Valrubicin is usually given during pregnancy only if the need for treatment of the mother outweighs the possible risk of harm to the baby.
It is not known whether valrubicin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How is valrubicin given?
Valrubicin is injected directly into the bladder using a catheter inserted into the urethra (the tube for passing urine out of your bladder). You will receive this medication in a clinic or hospital setting.
Valrubicin is usually given once per week for 6 weeks. This medicine is usually mixed into a solution that amounts to about 2.6 ounces (1/3 cup). This entire amount is injected into the bladder and should be held in for 2 hours.
Avoid using the bathroom for at least 2 hours after valrubicin is placed in your bladder. Tell your doctor if you have trouble holding in the medicine for the full 2 hours.
If this medicine accidentally gets on your skin, wash it thoroughly with soap and warm water.
Your doctor will need to check your progress with frequent urine tests while you are using valrubicin. You may also need to have a bladder biopsy or a bladder exam using a scope.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your valrubicin injection.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while using valrubicin?
This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.
Valrubicin side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
pain or burning when you urinate;
blood in your urine or painful urination lasting for longer than 24 hours; or
fever, stomach pain, nausea, diarrhea.
Common side effects may include:
red or pink urine within the first 24 hours after you receive valrubicin;
increased urge to urinate, urine leakage;
increase in night-time urinating; or
feeling like your bladder isn't completely empty.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: valrubicin side effects (in more detail)
Valrubicin Dosing Information
Usual Adult Dose for Urinary Tumor:
For intravesical therapy of BCG-refractory carcinoma in situ (CIS) of the urinary bladder in patients for whom immediate cystectomy would be associated with unacceptable morbidity or mortality:
Valrubicin is recommended at a dose of 800 mg administered intravesically once a week for six weeks. Administration should be delayed at least two weeks after transurethral resection and/or fulguration. For each instillation, four 5 mL vials (200 mg valrubicin/5 mL vial) should be allowed to warm slowly to room temperature, but should not be heated. Twenty milliliters of valrubicin should then be withdrawn from the four vials and diluted with 55 mL 0.9% Sodium Chloride Injection, USP providing 75 mL of a diluted valrubicin solution. A urethral catheter should then be inserted into the patient's bladder under aseptic conditions, the bladder drained, and the diluted 75 mL valrubicin solution instilled slowly via gravity flow over a period of several minutes. The catheter should then be withdrawn. The patient should retain the drug for two hours before voiding. At the end of two hours, all patients should void. (Some patients will be unable to retain the drug for the full two hours.) Patients should be instructed to maintain adequate hydration following treatment.
What other drugs will affect valrubicin?
Because valrubicin is not absorbed into the bloodstream, it is not likely that other drugs you take orally or inject will have an effect on valrubicin used in the bladder. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.
More valrubicin resources
Compare valrubicin with other medications
Where can I get more information?
- Your doctor or pharmacist can provide more information about valrubicin.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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