Epirubicin is a drug to treat several types of cancer, such as breast cancer or leukemia. This drug can be combined with other drugs, as an additional or adjuvant therapy in breast cancer patients who have undergone tumor removal surgery .

Epirubicin belongs to a class of anthracycline drugs. This drug works by slowing or stopping the growth of cancer cells. This medicine should not be used carelessly and should only be used under the supervision of a doctor.

Epirubicin trademarks: Ciazil, Epirol, Epirubicin HCL

What is Epirubicin

class Prescription drug
Category Anthracycline class anticancer
Benefit Treating certain types of cancer, such as leukemia, lymphoma, or breast cancer
Used by Mature
Epirubicin for pregnant and lactating women


Category D:  There is positive evidence of risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation.

It is not yet known whether epirubicin can be absorbed into breast milk or not. Breastfeeding women are advised to consult a doctor before using this drug.

Drug form Inject

Warning Before Using Epirubicin

Before using this drug, you need to pay attention to the following points:

  • Tell your doctor about any history of allergies you have. Epirubicin should not be given to patients who are allergic to this drug.
  • Tell your doctor if you have had or are currently having blood clotting disorders, gout,  liver disease , infection, kidney disease, or heart disease , including arrhythmias , heart attack, congestive heart failure .
  • Tell your doctor if you have had or are currently having radiotherapy or chemotherapy .
  • Tell your doctor if you plan to have any vaccinations while on epirubicin.
  • As much as possible avoid prolonged exposure to sunlight while undergoing treatment with epirubicin, because this drug can cause the skin to become more sensitive to light. Always use sunscreen when doing outdoor activities.
  • Tell your doctor if you are using epirubicin before having surgery, including dental surgery.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy. Use effective birth control while taking epirubicin.
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • See a doctor immediately if you have an allergic drug reaction , serious side effects, or an overdose after using epirubicin.

Dosage and Rules for Using Epirubicin

The dose of epirubicin will be given by the doctor according to the condition, body surface area, and the patient's response to treatment. The following is a general dose of epirubicin based on the patient's condition:

  • Condition: Breast cancer
    Initial dose 100–120 mg/m 2 , in a single dose or in 2 divided doses. If given in separate doses, the drug will be given on days 1 and 8 of each 28 day cycle. The drug will be given for 6 cycles.
  • Conditions: Lymphoma , acute leukemia, multiple myeloma , solid tumors
    60–90 mg/m 2 , every 3–4 weeks. Dosage can be divided into 2-3 days if needed. The maximum dose is 900–1000 mg/m 2

How to Use Epirubicin Properly

Epirubicin will be given directly by a doctor or medical officer under the supervision of a doctor. The medicine will be injected through a vein (intravenously/IV), according to the doctor's instructions. Epirubicin should not be injected other than through a vein, because it can cause tissue damage.

If there is contact between the drug and the skin, wash the area immediately with water. If the drug gets in the eyes, rinse eyes with water for 15 minutes and see a doctor immediately.

It is recommended to consume sufficient amounts of fluids while undergoing treatment with epirubicin to reduce the risk of side effects.

Follow the injection schedule given by the doctor for effective treatment. While on treatment, you may need to have regular medical tests to check your body's response to the drug.

Epirubicin Interactions with Other Drugs

The following are some of the effects of drug interactions that can occur when epirubicin is used with other drugs:

  • Increased risk of having an irregular heart rhythm (arrhythmia) when used with doxorubicin or antiarrhythmic drugs, such as quinidine,  amiodarone , procainamide
  • Increased blood levels of epirubicin when used with  cimetidine
  • Increased risk of liver damage when used with  paracetamol , ethanol, clavulanate or valproic acid 

Epirubicin Side Effects and Dangers

Some of the side effects that can occur after using epirubicin are:

  • Diarrhea
  • Warmth in the face, neck, or chest ( flushing )
  • Nausea or vomiting
  • Changes in skin or nail color
  • Hair loss
  • Red urine 1–2 days after injection

Consult a doctor if the side effects above do not subside immediately or get worse. You need to see a doctor immediately if you experience an allergic drug reaction or more serious side effects, such as:

  • Pain or sores in the mouth and throat
  • Changes in the menstrual cycle
  • Low back pain
  • Easy bruising
  • Chest pain, coughing up blood , or swelling of the legs
  • Fast or slow heart rate
  • Symptoms of dehydration , such as feeling very thirsty, urinating very rarely, or skin feeling dry
  • Signs of infection, such as fever , flu, canker sores that don't get better
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