Epirubicin

Epirubicin is a chemotherapy drug that is used in the treatment of some types of cancer including breast, ovarian, gastric, lymphoma and leukaemia. It may be helpful to read the general chemotherapy information section together with this section, as it will give more advice on chemotherapy side effects.

• What Epirubicin looks like?
• How is it given?
• Side effects
• Less common side effects
• Other information
• References

What Epirubicin looks like?

It is a red fluid.

How is it given?

Epirubicin is given as an injection or infusion intravenous  into a peripheral cannula or via a central line.

Side effects

The side effects mentioned below may not affect everyone, as each patient’s reaction to chemotherapy is different. It will also depend on how many chemotherapy drugs you are receiving. If you experience any effects that you think are related to your chemotherapy, please discuss them with your oncology doctor or chemotherapy nurse.

• Infection
• Anaemia
• Bruising
• Sore mouth
• Hair loss (alopecia)
• Changes to your heart
• Discoloured urine
• Fatigue
• Skin changes

Infection

You will be more prone to infection as Epirubicin affects your white cell production from the bone marrow. This effect usually occurs about 7 days after your chemotherapy. Your white cells however do gradually recover and are usually within normal ranges for your next chemotherapy course.
You should contact your doctor or the Oncology Unit straight away if you if you have a sore throat,cough, pain passing urine, redness and swelling at e.g. at a catheter site. Or have a temperature of 38 degrees° C or greater.

Anaemia

You may feel lethargic and breathless due to a reduction in your red cells caused by Epirubicin. Inform your doctor if you are feeling these effects.

Bruising

Epirubicin can also affect the production of platelets, which can cause bleeding or bruising. Inform your doctor if you notice any unexplained bleeding or bruising.

Sore mouth

You may develop a sore mouth or ulcers due to your chemotherapy. You will be prescribed some mouthwashes. Inform your doctor or nurse if your mouth becomes sore or you develop ulcers. You may also experience some taste changes, which will resolve when you finish your treatment.

Hair loss (alopecia)

You may lose all your hair or it may just thin out. This usually happens after your first course of chemotherapy. This is temporary and your hair will grow back.

Changes to your heart

Epirubicin can cause some damage to your heart muscle. This usually happens with continued use of the drug. You may have some tests to assess your heart function before your treatment. 

Discoloured urine

Due to the colour of the chemotherapy your urine will be a red/orange colour for a few hours after your treatment has completed.

Fatigue

You may feel very tired. This can last for a few months after your treatment. Inform your doctor or nurse of how you are feeling.

Skin changes

You may get some vein streaking where the chemotherapy is given in the arm or hand.
Epirubicin can sometimes cause a rash, which may be itchy. Inform your doctor if you notice a rash anywhere on your body.
Your skin may look darker due to increased pigmentation. This usually returns to normal after treatment has finished.

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Less common side effects

Diarrhoea

You may experience some diarrhoea. It is important to inform your doctor or nurse if you are having a lot of bowel motions in a day.

Changes to your nails

The colour of your nails may also change. This tends to grow out when treatment has completed.

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Other information

Fertility

It is important to discuss this with your doctor as Epirubicin may affect your fertility.

Contraception

It is important to use a reliable form of contraception while you are on treatment and for at least two years after your treatment has completed. It is not advised to get pregnant while on treatment as the drugs may affect the foetus.

Other medications

It is important to inform your doctor of any medications that you are taking, including over the counter medications or herbal drugs as they can interfere with some chemotherapy drugs.

References

• The Chemotherapy Source Book (2nd edition). M. Perry, Lippincott, Williams and Wilkins, 1997
• The Cytotoxics Handbook (3rd edition). M. Allwood, A. Stanley and P. Wright, Radcliffe Medical Press, Oxford and New York, 1997
• Handbook of Adult Cancer Chemotherapy Schedules (2nd edition). D. Dearnaley, I. Judson and T. Root, TMG Healthcare Communications, 2002
• Cancer Chemotherapy Handbook (2nd edition). D C Baquiran, Lippincotts, 2001

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