Epirubicin (Generic Name)
Other Names: Ellence®
About This Drug
Epirubicin is a drug used to treat cancer. This drug is given intravenously (IV).
Possible Side Effects (Most Common)
- Change in the color of your urine to pink or red. This color change will go away in one to two days, after treatment.
- Hair loss. Most patients experience scalp and body hair loss. You may notice hair thinning several days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
- Nausea and vomiting
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs 10 to 14 days after the drug is given, and may increase your risk of infection, fatigue, and bleeding.
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
- Nail changes. Your nails may change color or become brittle
- Decreased appetite
Possible Side Effects (Less Common)
- Skin and tissue irritation. This may include redness, pain, warmth, or swelling at the IV site. This occurs if the drug leaks out of the vein and into surrounding tissue.
- Changes in the tissue of the heart. Some changes may occur that can cause a decreased ability of your heart to pump blood. Your heart function will be checked as needed.
- Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to the effects of the sun, sun lamps, and tanning beds. Your eyes may water more, especially in bright light.
- Decreased appetite.
- Eye redness and irritation
- Risk of developing a secondary cancer
Sexual and Reproductive Concerns
In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 taking this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
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.
Speak with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
Genetic counseling is available to you to discuss the effect of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
Breast Feeding Warning: It is not known if this drug passes into breast milk. For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.
Women may experience signs of menopause like hot flushes and vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
Treating Side Effects
- Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
- Ask your doctor or nurse about medication to help prevent or lessen nausea and vomiting.
- Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeve shirts, and pants. Keep your neck, chest, and back covered.
- Use sunscreen with SPF 30 or higher when you are out in the sun, even for a short time.
- Avoid sun lamps, tanning booths, and tanning beds.
- Mouth care is very important. Your mouth care should consist of regular, 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 sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after very meal and at bedtime.
- If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
- Speak with your nurse about obtaining 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 undergoing chemotherapy 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 epirubicin with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.
While you are receiving this drug by IV, tell your nurse immediately if you have any of the following symptoms of an allergic reaction:
- Shortness of breath
- Rash or itching
- Dizziness or lightheadedness
- Feeling your heart beat rapidly (palpitations)
When to Call the Doctor
Call your doctor or nurse immediately if you have any of the following symptoms:
- Redness, pain, warmth, or swelling at the IV site
- Chest pain
- Rapid or irregular heart beat
- Difficulty catching your breath or wheezing
- Swelling of ankles
- Difficulty breathing when laying flat
- Fever of 100.5 F (38 C) or above
- Unusual bleeding or bruising
- Uncontrolled nausea that prevents you from eating or drinking
- Vomiting more than 3 times in 1 day
Call your doctor or nurse as soon as possible if you have any of the following symptoms:
- Painful mouth or throat that makes it difficult to eat or drink
- Persistent loss of appetite or rapid weight loss of 5 pounds in 1 week
Revised February 2011