Drug reference

Epirubicin hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 975

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Breast cancer (specialist use only) | Gastric cancer (specialist use only) | Small cell lung cancer (specialist use only) | Ovarian cancer (specialist use only) | Colorectal cancer (specialist use only) | Lymphoma (specialist use only) | Leukaemia (specialist use only) | Multiple myeloma (specialist use only) ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: (consult product literature or local protocols) Bladder cancer (specialist use only) ▶BY INTRAVESICAL INSTILLATION ▶Adult: (consult product literature or local protocols)

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Contra Indications

Bladder inﬂammation or contraction (when used as a bladder instillation). catheterisation difﬁculties (when used as a bladder instillation). haematuria (when used as a bladder instillation). invasive tumours penetrating the bladder (when used as a bladder instillation). myocardiopathy. previous treatment with maximum cumulative doses of epirubicin or other anthracycline. recent myocardial infarction. severe arrhythmia. severe myocardial insufﬁciency. unstable angina. urinary tract infections (when used as a bladder instillation)

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Cautions

Caution in handling—irritant to tissues

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Safety

Interactions

→Appendix 1: anthracyclines

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Side Effects

▶Common or very common ▶With intravesical use Chemical cystitis ▶With parenteral use Alopecia. amenorrhoea. anaemia. appetite decreased. arrhythmias. cardiac conduction disorders. chills. congestive heart failure. dehydration. diarrhoea. eye inﬂammation. fever. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. increased risk of infection. leucopenia. malaise. mucositis . nail discolouration. nausea. neutropenia. oral disorders. skin reactions. thrombocytopenia. urine discolouration. vasodilation. vomiting ▶Uncommon ▶With parenteral use Asthenia. embolism and thrombosis. sepsis ▶Rare or very rare ▶With parenteral use Hyperuricaemia ▶Frequency not known ▶With parenteral use Bone marrow depression. cardiomyopathy. cardiotoxicity. photosensitivity reaction . radiation injuries. shock SIDE-EFFECTS, FURTHER INFORMATION Manufactuer advises extreme caution with cumulative doses exceeding 900 mg/m2—risk of congestive heart failure increased.

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Conception And Contraception

Contraceptive advice required, see Pregnancy and reproductive function in Cytotoxic drugs p. 938.

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Pregnancy

Avoid (carcinogenic in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.

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Breast Feeding

Discontinue breast-feeding.

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Hepatic Impairment

Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment. Dose adjustments Manufacturer advises dose reduction according to bilirubin level.

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Renal Impairment

Dose adjustments Dose reduction may be necessary in severe impairment.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for injection, solution for infusion Solution for injection ▶Epirubicin hydrochloride (Non-proprietary) Epirubicin hydrochloride 2 mg per 1 ml Epirubicin 10mg/5ml solution for injection vials | 1 vial P £20.18 (Hospital only) | 1 vial P £17.38 Epirubicin 50mg/25ml solution for injection vials | 1 vial P £100.88 (Hospital only) | 1 vial P £86.89 ▶Pharmorubicin (Pfizer Ltd) Epirubicin hydrochloride 2 mg per 1 ml Pharmorubicin 50mg/25ml solution for injection Cytosafe vials | 1 vial P £106.19 (Hospital Immune system and malignant disease only) Pharmorubicin 10mg/5ml solution for injection Cytosafe vials | 1 vial P £21.24 (Hospital only) Solution for infusion ▶Epirubicin hydrochloride (Non-proprietary) Epirubicin hydrochloride 2 mg per 1 ml Epirubicin 200mg/100ml solution for infusion vials | 1 vial P £366.85 (Hospital only) | 1 vial P £306.20–£347.55 Epirubicin 100mg/50ml solution for infusion vials | 1 vial P £201.76 (Hospital only) ▶Pharmorubicin (Pfizer Ltd) Epirubicin hydrochloride 2 mg per 1 ml Pharmorubicin 200mg/100ml solution for infusion Cytosafe vials | 1 vial P £386.16 (Hospital only)

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Dose text by age group

Adult

(consult product literature or local protocols)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 975

Adult

(consult product literature or local protocols)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 975

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Epirubicin hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 975

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 975

Contra Indications

PDF page 975

Cautions

Caution in handling—irritant to tissues

PDF page 975

Safety

Interactions

→Appendix 1: anthracyclines

PDF page 975

Side Effects

PDF page 975

Conception And Contraception

Contraceptive advice required, see Pregnancy and reproductive function in Cytotoxic drugs p. 938.

PDF page 975

Pregnancy

Avoid (carcinogenic in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.

PDF page 975

Breast Feeding

Discontinue breast-feeding.

PDF page 975

Hepatic Impairment

Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment. Dose adjustments Manufacturer advises dose reduction according to bilirubin level.

PDF page 975

Renal Impairment

Dose adjustments Dose reduction may be necessary in severe impairment.

PDF page 975

Dose and formulations

Medicinal Forms

PDF page 975

Dose text by age group

Adult

(consult product literature or local protocols)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 975

Adult

(consult product literature or local protocols)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 975

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.