epirubicin hydrochloride at a glance
Medicine class
Anthracycline cytotoxic chemotherapy
How it is given
By a cancer specialist into a vein, or through a catheter into the bladder for selected bladder cancers
Important monitoring
Blood counts, liver function and heart function; renal function and tumour-lysis markers when clinically relevant
Expected colour change
Urine may temporarily turn red after intravenous treatment; bladder treatment can also discolour urine
What is epirubicin hydrochloride used for?
Selected UK products are licensed for intravenous treatment of several cancers and intravesical treatment of particular bladder cancers. Their exact licensed indications differ.
Breast, ovarian, stomach and lung cancers
Colorectal cancer, malignant lymphomas, leukaemias and multiple myeloma under the Pharmorubicin licence
Superficial bladder cancer and bladder carcinoma in situ
Prevention of superficial bladder-cancer recurrence after transurethral resection
How does epirubicin hydrochloride work?
Epirubicin enters cells and binds to DNA in the nucleus, interfering with nucleic-acid production and cell division. Rapidly dividing cancer cells are particularly vulnerable, although healthy rapidly dividing cells can also be affected.
epirubicin hydrochloride preparations and strengths
Injection
Route: Parenteral
Strengths: 2 mg/mL
How to take epirubicin hydrochloride
Epirubicin is prepared and administered by trained hospital staff; it is not taken by mouth. Intravenous administration requires careful vein placement because leakage can severely damage surrounding tissue. For bladder treatment, it is introduced through a catheter and retained before being passed. Follow the unit’s instructions about drinking beforehand and safe toileting afterwards.
Tell the nurse immediately about pain, burning, redness or swelling at the infusion site.
Tell the team about infections, mouth ulcers, heart, liver or kidney problems, recent vaccines and all medicines before treatment.
For intravesical treatment, follow the hospital’s fluid and bladder-emptying instructions.
epirubicin hydrochloride side effects
Common or expected effects
- Reduced blood-cell production, increasing susceptibility to infection, anaemia, bruising or bleeding
- Nausea, vomiting, diarrhoea, reduced appetite and abdominal discomfort
- Sore or inflamed mouth and digestive-tract lining
- Hair loss, skin changes and tiredness or malaise
- Temporary red urine after intravenous administration
- With bladder administration: burning, frequent urination, bladder discomfort and chemical cystitis
Get urgent medical advice
- Fever, shivering or other infection symptoms, including possible neutropenic sepsis
- Breathlessness, swelling, palpitations or chest symptoms suggesting heart damage or a blood clot
- Severe allergic reaction, including breathing difficulty or facial or throat swelling
- Unexpected or persistent bleeding
- Pain, burning, redness or swelling at the infusion site, which may indicate tissue-damaging extravasation
- Severe bladder pain, persistent blood in urine or inability to pass urine after intravesical treatment
epirubicin hydrochloride in pregnancy
Epirubicin may harm an unborn baby and is generally avoided during the first trimester. Use later in pregnancy requires individual specialist assessment; fetal or neonatal heart monitoring may be needed after exposure. Tell the oncology team immediately about pregnancy or pregnancy plans, use effective contraception for the product-specific period advised, and discuss fertility preservation before treatment where appropriate.
epirubicin hydrochloride while breastfeeding
Breastfeeding is contraindicated during treatment because of the potential for serious effects in the infant. Ask the oncology team when breastfeeding may safely restart, as the product information specifies a waiting period.
epirubicin hydrochloride interactions
The cancer team should review prescribed, over-the-counter and complementary medicines before treatment.
Other cardiotoxic treatments, including trastuzumab and some cancer medicines
Heart-damage risk may increase, requiring careful sequencing and cardiac monitoring.
Other bone-marrow-suppressing medicines
Additive suppression can increase infection, anaemia and bleeding risks.
Common questions about epirubicin hydrochloride
Answers are fully visible for fast scanning and source review.
Why is epirubicin called an anthracycline?
It belongs to a family of cytotoxic antibiotics that bind to DNA and disrupt cell division.
Why is epirubicin sometimes called red chemotherapy?
The prepared solution is red and can temporarily make urine red after intravenous treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.