Daunorubicin (Generic Name)

Other Names: Cerubidine®
 

About this drug

Daunorubicin is a drug used to treat cancer. It is given in the vein (IV).

Possible side effects (common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression most often happens 7 to 14 days after the drug is given and may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 to 48 hours.
  • Hair loss. Hair loss is often on the whole scalp and can involve loss of eyebrows, eyelashes, and pubic hair. You may notice hair getting thin. Most often hair loss is temporary; your hair should grow back when treatment is done.
  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
  • Effects on the heart. This drug can weaken the heart and decrease heart function. Your heart function will be checked as needed. You may have trouble catching your breath, mainly during activities. You may also have trouble breathing while lying down, and have swelling in your ankles. 
  • Changes in your liver function. Your doctor will check your liver function as needed.
  • Urine color may be slightly pink or red starting several hours after you get this drug. This will slowly go away within one to two days.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Loose bowel movements (diarrhea) that may last for a few days.

Treating side effects

  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, throwing up (vomiting), and loose bowel movements.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime. 
  • If you have mouth sores, avoid mouthwash that has alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • During the IV infusion, if you have pain, redness, or swelling at the site of the IV infusion, please tell your nurse right away.
  • Talk with your nurse about getting a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.

Food and drug interactions

There are no known interactions of daunorubicin with food. There are known possible interactions with trastuzumab (Herceptin), paclitaxel (Taxol), and docetaxel (Taxol). Talk with your doctor if you are taking any of those medicines before starting this one. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

Important instructions

 Talk with your doctor before getting any vaccines while taking daunorubicin.

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Nausea that stops you from eating or drinking
  • Throwing up more than three times in one day
  • Redness, pain, warmth, or swelling at the IV site while you are getting this drug
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Rapid or irregular heart beat
  • Wheezing or trouble breathing
  • Trouble breathing while lying down

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Nausea that is not relieved by prescribed medication
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Loose bowel movements (diarrhea) 4 times in a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Swelling of legs, ankles or feet

Sexual problems and reproductive concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In men and women both, this drug may affect your ability to have children. This cannot be determined before your therapy. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking. 
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. 
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations. 
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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