Epirubicin Injection (patient information)

# IMPORTANT WARNING
Epirubicin may cause severe heart damage, even months or years after you have stopped taking the drug. Epirubicin may also cause a decrease in the number of blood cells.
Tell your doctor if you have ever had chemotherapy with daunorubicin (Cerubidine, DaunoXome), doxorubicin (Adriamycin, Doxil, Rubex), epirubicin, idarubicin (Idamycin), mitoxantrone (Novantrone), or valrubicin (Valstar) or radiation therapy to the chest and if you are taking calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan) or cyclophosphamide (Cytoxan, Neosar). Tell your doctor if you have or have ever had heart or liver disease.
If you experience any of the following symptoms, call your doctor immediately: rapid heartbeat; shortness of breath; swelling of the hands, feet, ankles, or lower legs; swelling of the stomach; unusual bleeding or bruising; pale skin; lack of energy; or fever, sore throat, chills, and other signs of infection.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before, during, and after your treatment to check your body's response to epirubicin.
Epirubicin has been associated with the development of other types of cancer. Talk with your doctor about the risk of developing a new cancer.

# About your treatment
Your doctor has ordered the drug epirubicin to help treat your illness. The drug is given by injection into a vein.
This medication is used to treat:
- breast cancer
Epirubicin is in a class of drugs known as anthracyclines; it slows or stops the growth of cancer cells in your body. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Precautions
Before taking epirubicin:
- tell your doctor and pharmacist if you are allergic to epirubicin, daunorubicin (Cerubidine, DaunoXome), doxorubicin (Adriamycin, Doxil, Rubex), idarubicin (Idamycin), or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: cimetidine (Tagamet) and other chemotherapy drugs. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had gout or kidney disease.
- you should know that epirubicin may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Epirubicin may harm the fetus.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Epirubicin may make your skin sensitive to sunlight.
- do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

# Side effects

## Minor side effects
Epirubicin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nausea
- diarrhea
- swelling or bruising in the mouth
- hair loss
- hot flashes
- tiredness

## Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT WARNING section, call your doctor immediately:
- vomiting
- dehydration
- pain at the site of injection
- hives
- difficulty breathing or swallowing
Epirubicin may cause other side effects. Call your doctor if you have any unusual problems while taking this drug.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Special instructions
You should know that your urine may appear red for 1 to 2 days after a dose of epirubicin.

# Brand names
- Ellence