Epirubicin Hydrochloride Injection

• Type: Chemotherapy medication

• Drug Class: Anthracycline antineoplastic agent

• Form: Sterile solution for intravenous (IV) administration

How It Works

• Epirubicin works by:

  • Intercalating into DNA, preventing the DNA from unwinding and replicating

  • Inhibiting topoisomerase II, an enzyme required for DNA repair and replication

  • Generating free radicals, which damage cancer cell membranes, DNA, and proteins

• These effects lead to cell death, especially in rapidly dividing cancer cells.

Common Uses

Epirubicin is used to treat several types of cancer, including:

• Breast cancer (often as part of combination chemotherapy regimens like FEC)

• Ovarian cancer

• Stomach (gastric) cancer

• Lung cancer (small cell or non-small cell, in combination regimens)

• Bladder cancer (can also be used intravesically for superficial bladder tumors)

Advantages

• Slightly less cardiotoxic than doxorubicin (its close relative), allowing higher cumulative doses

• Effective as part of adjuvant chemotherapy to reduce cancer recurrence risk

• Can be used in both early and advanced cancers

Possible Side Effects

Common:

• Hair loss (alopecia)

• Nausea, vomiting

• Fatigue

• Low blood counts (neutropenia, anemia, thrombocytopenia)

• Mouth sores (mucositis)

• Red/orange discoloration of urine (temporary)

Serious but Less Common:

• Heart toxicity (cardiomyopathy, heart failure) at high cumulative doses

• Severe bone marrow suppression leading to infections

• Liver function abnormalities

• Extravasation risk – leakage outside the vein can cause severe tissue damage

Precautions

• Heart function should be checked before and during treatment (echocardiogram or MUGA scan)

• Dose adjustments needed for patients with liver impairment

• Avoid live vaccines during treatment (immune suppression risk)

• Administer via a well-functioning IV line to prevent tissue damage