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Epirubicin (Ellence )     

Warning: Since Epirubicin must be injected directly into the blood stream, it’s very important that the injection be put in a vein rather than into a muscle like many other injections. If the injection is performed improperly, it can cause major damage.  Epirubicin has been known to cause severe (but hardly ever fatal) heart problems (including while using the medication, and up to years after using it), bone marrow and blood issues, and, in very infrequent situations, the source of other types of cancers, such as leukemia. If people using the drug are noticing an irregular heartbeat, easy bruising, a rash, or increased levels of itching, it would be advised that they speak to their health care professional as quickly as they possibly can. Side effects that can be a result of using this drug include symptoms that could be described as flu like (vomiting, diarrhea, etc.), redness of the urine (which is definitely distressing, but is expected and not abnormal), tenderness and sores that sometimes develop in the mouth, and loss of hair. In some cases (but much more rarely), users can develop serious allergies to this medication. If you notice a high amount of swelling, redness, or itchiness around the area of the injection, it’s recommended that you contact your health care provider as soon as possible.

 

Indications : Epirubicin is a liquefied medicine that is injected directly into the blood stream by way of a syringe. Its usage is helpful in the slowing or stopping of cancer cells in the body. Because of the precise way in which the injection must be administered, it needs to be done only by a health care professional. If done improperly, the injection can cause major damage, so it’s certainly important that it only be done by a health care professional.

Epirubicin is used - in combination with other cytostatics - in the treatment of the following medical conditions: 

  • stomach cancer 
  • liver cancer 
  • oral cancer 
  • pancreatic cancer 
  • ovarian cancer 
  • hodgkin's Lymphoma 
  • soft tissue sarcoma 
  • esophageal cancer 
  • non-Hodgkin lymphoma (NHL or just lymphoma) 
  • Small cell lung cancer 

Dosage:  Because the injections of epirubicin can only be given by a licensed health care provider, it’s advised that users talk the number of injections that are needed with their health care provider before beginning usage. The amount of time needed for using epirubicin depends upon the other kinds of treatments you’re having administered, and how your body responds to the medicine alongside the other kinds of treatments you might be enduring.

The recommended dose of Epirubicin varies depending on the severity of the cancer, your age, health in general, and other medications you are taking. Your weight will also be taken in consideration in the choice of the treatment. Epirubicin is given intravenously in a hospital or in a medical center. The drug must be prepared and administered by medical specialists. In general, Epirubicin is administered at intervals of three to four weeks. Epirubicin can be taken alone or in combination with other anticancer drugs.  

 

Depending on the reaction of your body to the drug, your oncologist may adjust the dosage. A lower dose may be recommended if you are elderly or if your bone marrow function has been disrupted by prior chemotherapy or radiotherapy.  

Interactions: It is important that before using epirubicin that you let your doctor know of any allergies to any medicine that you suffer from, and let him or her know about any other types of medicine you’re already using.

The medication is not recommended in the following conditions:

  • pregnancy/breastfeeding  
  • liver failure  
  • kidney failure   
  • allergy to epirubicin or any of its ingredients   
  • low blood counts due to bone marrow disorder  
  • history of serious heart disease   
  • History of treatment by epirubicin or by any anthracycline such as doxorubicin, daunorubicin, mitoxantrone or mitocyne C.   

Interactions:  Tell your oncologist if you are taking any prescription or non prescription medications.  Some medications may affect therapeutic effects of Epirubicin, or increase the risk of developing side effects. Always consult with your doctor before taking these medicines:     

  • Ganciclovir, an antiviral drug 
  • Azathioprine, an immune system inhibitor  
  • Barbiturates,  depressant drug that causes relaxation and sleepiness 
  • Cimetidine  , a drug used to inhibit the production of acid in the stomach 
  • Colchicines  , a medication used to treat pain of gouty arthritis 
  • Live vaccines: BCG vaccine, yellow fever vaccine, etc.   
  • Cyclophosphamide  (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers 
  • Cyclophosphamide  (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers 
  • Celecoxib, a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, painful menstruation, colon and rectum polyps, etc. 

Side effects: Common  Epirubicin side effects include:  

  • mouth sores  
  • hair loss  
  • hot flashes  
  • tiredness  
  • decreased appetite  
  • weight loss   
  • diarrhea or constipation   
  • Nausea and vomiting.   

If the side effects above become worse or persit in spite of treatment you need to contact your doctor immediately. It is also important to report any of these symptoms:  

  • Persistent fever  
  • chills  
  • persistent cough   
  • bloody diarrhea  
  • shortness of breath or breathing difficulty   
  • unusual bruising or bleeding  
  • sensitivity of skin to sunlight  
  • tingling in the hands or feet  
  • severe clinical depression symptoms 
  • Drying or darkening of the skin or nails.   

 

References: 

 

1 - ch.oddb.org/fr,  

2 - nlm.nih.gov