Drug reference

Epirubicin

Anthracycline · Antineoplastic

Also known as Epirubicin hydrochloride

AnthracyclineAntineoplastic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactionssee all 12 →

Live VaccinesContraindicatedDatabase
AdalimumabSevereDatabaseDDInter
AmiodaroneSevereDatabaseDDInter
AmisulprideSevereDatabaseDDInter

Mechanism

Epirubicin is an anthracycline antibiotic structurally related to doxorubicin hydrochloride. Like many cytotoxic antibiotics, it acts as a radiomimetic.

Indications

Treatment and prophylaxis of certain forms of superficial bladder cancerBreast cancerAdjunctive therapy for treatment of breast cancerAdjuvant therapy of breast carcinomaGastroesophageal carcinomaPancreatic carcinomaHepatic carcinomaBladder carcinoma

Dosing

Adult: 50 ml . NHS indicative price = £3.70 . Drug Tariff (Part IXa)100 ml . NHS. 100 ml . NHS indicative price = £3.49 . Drug Tariff (Part IXa). 60 ml . NHS indicative price = £4.94 . Drug Tariff (Part IXa)

Pharmacokinetics

Protein binding

Rapidly enters the heart, kidneys, lungs, liver, and spleen; does not cross the blood-brain barrier.

Metabolism

Converted to an active alcohol intermediate.

Excretion

Cleared by a complex pattern of hepatic metabolism and biliary excretion.

Side effects

Common

Micturition disorders (from bladder instillation)Reduction in bladder capacity (from bladder instillation)Bone marrow depressionStomatitisAlopeciaGastrointestinal disturbancesRashCardiac toxicity (acute or chronic)Hyperpigmentation of skin and oral mucosaPainful oral ulcersFeverG.i. symptomsRed urine

Serious

Cardiotoxicity (dose-dependent, similar to doxorubicin)
Cardiotoxicity (dose related)

Drug interactions

Live Vaccines

Contraindicated

Database

Disseminated infection from the live vaccine, potentially fatal.

Live vaccines are contraindicated during epirubicin therapy and for a period after treatment (typically 3-6 months, depending on the vaccine and immune recovery). Inactivated vaccines may be less effective.

Adalimumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amiodarone

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amisulpride

Severe