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Generic Name: epirubicin (EP i ROO bi sin)
Brand Name: Ellence, Pharmorubicin PFS, Pharmorubicin RDF

Medically reviewed by on Sep 30, 2019 – Written by Cerner Multum

What is epirubicin?

Epirubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Epirubicin is used to treat breast cancer.

Epirubicin may also be used for purposes not listed in this medication guide.

Important Information

You should not use this medication if you have an untreated or uncontrolled infection, severe liver disease, severe heart problems, or if you have recently had a heart attack.

Epirubicin may cause dangerous effects on your heart. Call your doctor at once if you have chest pain, shortness of breath (even with mild exertion), swelling, or rapid weight gain.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when epirubicin is injected. Call your doctor if you have irritation or skin changes where the injection was given.

Epirubicin can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

Using epirubicin may increase your risk of other types of cancer, such as leukemia.

Before taking this medicine

Before you are treated with epirubicin, tell your doctor about all other cancer medications and treatments you have received, including radiation.

You should not use this medication if you are allergic to epirubicin or similar medications (Cerubidine, Adriamycin, Idamycin, Novantrone), or if you have:

  • an untreated or uncontrolled infection (including mouth sores);

  • severe liver disease;

  • severe heart problems; or

  • if you have recently had a heart attack.

To make sure epirubicin is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • bone marrow suppression;

  • heart disease; or

  • if you have been treated before with doxorubicin, daunorubicin, epirubicin, idarubicin, or mitoxantrone.

Using epirubicin may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

Do not use epirubicin if you are pregnant. It could harm the unborn baby. Tell your doctor if you become pregnant during treatment.

Use birth control to prevent pregnancy while you are receiving epirubicin, whether you are a man or a woman. Epirubicin use by either parent may cause birth defects.

It is not known whether epirubicin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using epirubicin.

How is epirubicin given?

Epirubicin is injected into a vein through an IV. A healthcare provider will give you this injection.

Epirubicin is usually given together with other cancer medications. You may be given other medications to prevent nausea, vomiting, or infections.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when epirubicin is injected.

If any of this medication accidentally gets on your skin, wash it thoroughly with soap and warm water.

Epirubicin can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your epirubicin injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving epirubicin?

epirubicin can pass into body fluids (urine, feces, vomit). 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. Caregivers should wear rubber gloves while cleaning up a patient's 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.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using epirubicin, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Epirubicin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have:

  • feeling short of breath, even with mild exertion;

  • swelling, rapid weight gain (especially in your face and midsection);

  • irritation or skin changes where the injection was given;

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • fast, slow, or uneven heartbeats;

  • anxiety, sweating, severe shortness of breath, wheezing, gasping for breath;

  • chest pain, sudden cough, cough with foamy mucus, rapid breathing, coughing up blood;

  • lower back pain, blood in your urine, little or no urinating;

  • numbness or tingly feeling around your mouth, weak pulse, overactive reflexes, confusion, fainting;

  • muscle weakness, tightness, or contraction;

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat; or

  • pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Common side effects may include:

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.

Epirubicin dosing information

Usual Adult Dose for Breast Cancer -- Adjuvant:

Initial dose: 100 to 120 mg/m2 IV in repeated 3- to 4-week cycles; either total dose on Day 1 of each cycle, or divided equally and given on Days 1 and 8 of each cycle

CEF-120 regimen (repeat every 28 days for 6 cycles):
-Cyclophosphamide: 75 mg/m2 orally on Days 1 to 14
-Epirubicin: 60 mg/m2 IV on Days 1 and 8
-5-Fluorouracil: 500 mg/m2 IV on Days 1 and 8

FEC-100 regimen (repeat every 21 days for 6 cycles):
-5-Fluorouracil: 500 mg/m2 IV on Day 1
-Epirubicin: 100 mg/m2 IV on Day 1
-Cyclophosphamide: 500 mg/m2 IV on Day 1

Recommended infusion rates:
-For starting doses of 100 to 120 mg/m2, give the infusion over 15 to 20 minutes.
-For patients who require lower starting doses due to organ dysfunction or who require modification of doses during therapy, the infusion time may be proportionally decreased, but should not be less than 3 minutes to minimize the risk of thrombosis or perivenous extravasation, which could lead to severe cellulitis, vesication, or tissue necrosis.
-A direct push injection is not recommended due to the risk of extravasation, which may occur even in the presence of adequate blood return upon needle aspiration. Venous sclerosis may result from injection into small vessels or repeated injections into the same vein.

-Doses are manufacturer suggested. Consult local protocol.
-Consider use of antiemetics when given in conjunction with other emetogenic drugs.
-Patients administered the 120 mg/m2 regimen should receive prophylactic antibiotics.

Use: As adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer

What other drugs will affect epirubicin?

Many drugs can interact with epirubicin. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with epirubicin, especially:

This list is not complete and many other drugs can interact with epirubicin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.