Epirubicin review

Epirubicin is an injectable anthracycline drug. Anthracycline drugs are drugs derived from Streptomyces bacteria which are used in cancer chemotherapy. Anthracycline drugs may combat various forms of cancer ranging from leukemias, breast, lung, uterine and ovarian cancers to lymphomas.

Like other anthracycline drugs, the main action of epirubicin is to intercalate DNA strands. This intercalation produces complex formation that holds back RNA and DNA formation. It may also trigger cleavage of DNA by topoisomerase II, which may result to cell death. Epirubicin also generates free radicals causing damage in cancer cells and DNA.

Epirubicin hydrochloride is also known as Ellence, an injectable drug used as a component in adjuvant therapy for treating patients with the formations of auxiliary node tumors following resection of primary breast cancer. Its main action is to stop cancer cells from growing.

Ellence is supplied in vials of 50mg/ 25mL and 200/ 100ml mg of epirubicin. Each milliliter of the solution contains 2mg of epirubicin hydrochloride. Epirubicin injectable is given through intravenous infusion. Administration of the drug may be given in 3-to-4 week cycles repeatedly. The recommended starting dose for epirubicin is 100 to 120 mg/m2

Some common side effects that may occur upon use of epirubicin are nausea, hair loss and diarrhea. If these conditions worsen, a doctor or physician must be contacted. Urine may turn red upon usage of the drug. Serious side effects such as pain in the injection site, sore throat, bleeding or bruising, fever and unusual tiredness may be experienced. Irregular heartbeats, loss of weight, loss of appetite, photosensitivity and chest pains may also occur. Allergic reactions are unlikely, but must be reported once felt. Allergic reactions include swelling, itching, and rashes.

Epirubicin may not be used in patients with hypersensitivity or allergy to epirubicin or any of its ingredients. Patients allergic to anthracyclines such as doxorubicin, and to anthrecenediones such as mitoxantrone are not advised to use epirubicin.

Epirubicin used together with cytotoxic drugs have shown to increase the toxicity levels in the body, especially increasing hematologic and gastrointestinal effects. Cardioactive drugs may cause heart failure if used with epirubucin, hence close monitoring is needed. Epirubicin is extensively metabolized in the liver. Drugs that may affect liver function must be given caution as it may alter the effects of epirubicin.

Physicians must be informed of any prescription or non-prescription drugs used by the patient prior to epirubicin use. Such drugs include other chemotherapy drugs, beta-blockers, and calcium blockers.

Epirubicin is not recommended for use if a patient has any of the following conditions: heart problems such as myocardial infarction, marrow conditions such as leucopenia, and liver problems.

Caution is to be advised when administering the drug to the elderly and children as they may be more sensitive to the effects. Epirubicin has been found out to affect both sperm production and may interfere the menstrual cycle and eventually cause premature menopause.

Epirubicin is not recommended for use by pregnant women. Epirubicin may pass in to breast milk. Nursing mothers are not recommended to use this drug.

Epirubicin has the following structural formula:

Chemical structure of epirubicin

• Molecular formula of epirubicin is C27H29NO11
• Chemical IUPAC Name is 10-(4-amino-5-hydroxy-6-methyl-oxan-2-yl)oxy-6,8,11-trihydroxy-8-(2-hydroxyacetyl)- 1-methoxy-9,10-dihydro-7H-tetracene-5,12-dione
• Molecular weight is 543.519 g/mol
Epirubicin available : 50mg tablets and 200mg tablets

Brand name(s): Ellence, Epi-Dx, Epiadriamycin, Epidoxorubicin, Epirubicina, Epirubicine, Epirubicinum, Pidorubicina, Pidorubicine, Pidorubicinum, Ridorubicin

  Your Epirubicin review