What is Epirubicin Hydrochloride Injection?

Epirubicin Hydrochloride Injection is a strong chemotherapy drug that is mostly used to treat different types of cancer, especially breast cancer, which is still in its early stages.

It is a different form of anthracycline that has a structure similar to doxorubicin but a changed side chain that makes it less harmful to the heart.

The way epirubicin works is by stopping cancer cells from growing, which kills them in the end.

Overview

Description

Epirubicin Hydrochloride is a semi-synthetic analog of doxorubicin, distinguished by a modification at the 4′ position of the sugar molecule.

The medication is formulated as a red-orange solution for intravenous administration.

Each milliliter comprises Epirubicin Hydrochloride (equal to epirubicin base), typically 2 mg/mL

Excipients: Sodium chloride, hydrochloric acid (for pH adjustment), and Water for Injection

It is a cytotoxic anthracycline antibiotic that targets DNA to provide its anti-tumor actions.

Uses / Indications

Metastatic breast cancer

Gastric cancer

Ovarian carcinoma

Non-small cell lung cancer (NSCLC)

Hepatocellular carcinoma

Bladder cancer

Benefits

The overall survival rate and the percentage of breast cancer patients who are disease-free are both improved.

Because it is less cardiotoxic than doxorubicin, increased cumulative dosages can be administered to certain patients.

Used in the treatment of a wide spectrum of solid and hematological cancers.

Strong efficacy can be achieved by the use of well-established combination regimens, such as CEF, EC, and ECF.

Side Effects

How Does It Work?

Cancer cells’ DNA is messed up by epirubicin, which is how it works.

By intercalating itself into DNA strands, it stops enzymes like topoisomerase II from doing their job of copying and fixing DNA.

This breaks down the DNA, which stops the cancer cells from spreading and dividing.

Also, epirubicin makes free radicals that hurt parts of cells and eventually cause apoptosis, which is the death of rapidly developing tumor cells.

Directions for Use

Only intravenously (IV) is administered; no intramuscular or intrathecal administration occurs.

Dosage is determined by body surface area (mg/m²) and kind of malignancy.

Typically administered slowly over 3-20 minutes by central or peripheral vein.

Use a central venous catheter to reduce the risk of extravasation.

Refrain from mixing with other medicines in the same infusion line.

When Not to Use

Epirubicin or other anthracyclines are known to cause allergies or high levels of sensitivity.

People whose livers are severely damaged or whose liver function tests come back odd.

A history of chronic heart failure or a low LVEF will be taken into account.

Before, the total amount of anthracycline taken was more than what is suggested.

Drug Interactions

The co-administration of trastuzumab elevates the risk of heart failure.

Administering paclitaxel or docetaxel prior to epirubicin may amplify its toxicity.

CYP3A4 inhibitors, such as ketoconazole, can elevate epirubicin plasma concentrations.

Live vaccinations can induce serious infections as a result of immune suppression.

Additional anthracyclines or alkylating drugs augment cumulative toxicity.

Safety Advice

Pregnancy Category D – Conclusive evidence of danger to human fetuses; use is not advised unless critically required.

Employ reliable contraception during therapy and for six months thereafter.

Refrain from breastfeeding while undergoing therapy.

People with hepatic or renal impairment should be administered modified dosages.

Utilize central venous access to mitigate extravasation hazards.

General Instructions

Report right away any chest pain, shortness of breath, fever, or other signs of an infection.

Stay away from busy places and sick people.

Rinse your mouth out often to lower your risk of mucositis.

Do not miss any doses; stick to the treatment plan.

It’s normal and safe to have red pee after getting an injection.

Special Dietary / Lifestyle Advice

Patients undergoing Epirubicin Hydrochloride Injection should eat a well-balanced diet rich in fruits, vegetables, and lean proteins to support immunological function and recuperation.

Staying hydrated is essential for flushing the medication and its metabolites from the body.

Avoid alcohol and tobacco, as these can put a burden on your liver and heart.

Light physical activity, such as walking, can assist in reducing fatigue, but strenuous exercise should be avoided throughout therapy.

Take care of your teeth to prevent mouth sores.

Also, avoid sun exposure since the medicine can make your skin sensitive.

Comparison with Other Treatments

In some patients, epirubicin can be given higher cumulative doses than doxorubicin since it has a lower cardiotoxicity risk.

Both treat breast and other solid tumors; however, epirubicin is safer for borderline cardiac patients.

Epirubicin is less expensive and more commonly used in chemotherapy than liposomal doxorubicin.

However, it leads to more hair loss and mucositis.

It is sometimes recommended over mitoxantrone, which has less cardiac risk but weaker anti-tumor effectiveness.

Precautions & Warnings

Patients with pre-existing cardiac disease should exercise caution.

Keep an eye on the total dosage (no more than 900 mg/m2) to prevent heart damage.

Think about baseline and recurring echocardiograms.

As a vesicant, epirubicin should be handled carefully to avoid extravasation.

May result in infertility, either temporarily or permanently.

Can It Be Used With Other Medications?

Cyclophosphamide + 5-FU (CEF regimen) – standard in breast cancer

Docetaxel (EC-T regimen) – highly effective in early breast cancer

Cisplatin + 5-FU (ECF regimen) – used for gastric cancers

Trastuzumab or lapatinib – monitor heart function closely

Other anthracyclines or alkylating agents – cumulative toxicity

Hepatotoxic drugs (e.g., methotrexate) – adjust the dose

Storage

Refrigerate and keep at 2 to 8 degrees Celsius.

Be careful not to freeze

Shield from intense heat and light.

Reconstitute and use within 24 hours if kept refrigerated.

Because it is cytotoxic, dispose of any leftovers in a secure manner.