Epirubicin (Generic Name)
Other Names: Ellence®
About This Drug
Epirubicin is a drug used to treat cancer. This drug is given in the vein (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: Hair loss is often complete scalp hair loss and can involve loss of eyebrows, eyelashes, and pubic hair. You may notice this a few days or weeks after treatment has started. Most often hair loss is temporary; your hair should grow back when treatment is done.
- Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 72 hours. Medicines are available to stop or lessen these side effects.
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression often happens 10 to 14 days after the drug is given. This may raise your risk of infection, make you tired a weak (fatigue), and raise your risk of bleeding.
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
- Nail changes. Your nails may change color or become brittle
Possible Side Effects (Less Common)
- Skin and tissue irritation. This may include redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
- Decreased appetite (decreased hunger).
- Changes in the tissue of the heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.
- This drug can weaken the heart and lower 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.
- Congestive heart failure. You may be short of breath. Your arms, hands, legs and feet may swell.
- Abnormal heart beat. Your heart tissue can be harmed. This may cause your heart to beat in a way that is not normal. Your doctor may order an EKG to check this.
- Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to light from the sun, sun lamps, and tanning beds. Your eyes may water more, mostly in bright light.
- Eye irritation. You may have watery eyes. Your eyes and eye lids may become red and painful.
- Changes in your liver function. Your doctor will check your liver function as needed.
- This drug may cause an increased risk of developing a second cancer.
While you are getting this drug in your vein (IV), you may have a reaction. Your nurse will check you closely for the these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
These reactions may happen up to 24 hours after you get this drug. Call 911 for emergency care.
Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein (IV), tell your nurse right way if you have any of the these symptoms of an allergic reaction:
- Trouble catching your breath
- Feeling like your tongue or throat are swelling
- Feeling your heart beat quickly or in a not normal way (palpitations)
- Feeling dizzy or lightheaded
- Flushing, itching, rash, and/or hives
Treating Side Effects
- Drink 6-8 cups of fluids every 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 from losing too much fluid).
- Ask your doctor or nurse about medicine to help stop or lessen nausea and vomiting or loose bowel movements.
- Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
- Wear dark sun glasses when in the sun or bright lights.
- 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 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 contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
- Talk with your nurse about obtaining a wig before you lose your hair. Also, call the American Cancer Society at 800-ACS-2345to 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.
- While getting this drug tell your nurse right away if you have any pain, redness or swelling at the site of the IV infusion.
Food and Drug Interactions
There are no known interactions of epirubicin with food. 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.
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
- Easy bruising or bleeding
- Wheezing or trouble breathing
- Rash or itching
- Feeling dizzy or lightheaded
- Feeling that your heart is beating in a fast or not normal way (palpitations)
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Blurred vision or other changes in eyesight
- Pain when passing urine; blood in urine
- Pain in your lower back or side
- Feeling confused or agitated
- Nausea that stops you from eating or drinking
- Throwing up more than 3 times a day
- 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.
- Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
- Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin.
Call your doctor or nurse as soon as possible if any of these symptoms happen:
- Change in hearing or ringing in the ears
- Decreased urine
- Unusual thirst or passing urine often
- Pain in your mouth or throat that makes it hard to eat or drink
- Nausea that is not relieved by prescribed medicines
- Rash that is not relieved by prescribed medicines
- Heavy menstrual period that lasts longer than normal
- Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
- Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Fatigue that interferes with your daily activities
- Headache that does not go away
- Painful, red, or swollen areas on your hands or feet.
- No bowel movement for 3 days or you feel uncomfortable
- Extreme weakness that interferes with normal activities
Sexual problems and reproduction concerns may happen. In both men and women, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your treatment. 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 taking 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.
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.
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.
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