Medicine Information

Epirubicin-Aqvida

Name: Epirubicin-Aqvida
Brand: Epirubicin-Aqvida
Rating: 4.5 (117 reviews)

Powder for solution for injection2 mg/vialAntineoplastic (Cytotoxic), AnthracyclinesATC: L01DB03

Generic Name

Epirubicin Hydrochloride

Manufacturer

Aqvida GmbH

Country

Germany

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
epirubicin aqvida 2 mg injection	৳ 4,900.00	N/A

Description

Overview of the medicine

Epirubicin is an anthracycline cytotoxic agent used in chemotherapy for various cancers. It works by interfering with DNA and RNA synthesis in cancer cells, thereby inhibiting their growth and causing their death. It is administered intravenously.

Uses & Indications

Breast cancer (adjuvant and metastatic)

Gastric cancer

Ovarian cancer

Small cell lung cancer

Non-Hodgkin's lymphoma

Bladder cancer (intravesical for superficial bladder carcinoma)

Dosage

Adults

Dosage varies widely based on cancer type, stage, and combination therapy. Common intravenous doses range from 60-120 mg/m² administered every 3-4 weeks. Intravesical doses typically 50 mg in 50 mL saline weekly for 8 weeks.

Elderly

No specific dose reduction recommended based solely on age, but close monitoring of cardiac and hematopoietic function is crucial. Dose reduction may be considered if co-morbidities or impaired organ function exist.

Renal_impairment

No dosage adjustment is generally required for mild to moderate renal impairment. For severe renal impairment (serum creatinine > 5 mg/dL), a dose reduction of 50% should be considered.

How to Take

Administer intravenously via a free-flowing intravenous infusion over 3-5 minutes, or intravesically (for bladder cancer). Avoid rapid bolus injection. Extravasation can cause severe local necrosis.

Mechanism of Action

Epirubicin intercalates with DNA, thereby inhibiting nucleic acid synthesis and topoisomerase II activity. It also generates free radicals and binds to cell membranes, contributing to its cytotoxic effects against rapidly proliferating cancer cells.

Pharmacokinetics

Onset

Rapid distribution into tissues following intravenous injection.

Excretion

Excretion primarily occurs via the biliary route (60-80% of dose). Renal excretion accounts for a smaller proportion (9-12%).

Half life

Biphasic elimination with a mean terminal half-life of approximately 30-40 hours.

Absorption

Rapid and complete absorption after intravenous administration.

Metabolism

Extensively metabolized in the liver (and other tissues) primarily via carbonyl reduction to epirubicinol and by conjugation with glucuronic acid.

Side Effects

Contraindications

Hypersensitivity to epirubicin, other anthracyclines, or anthracenediones
Persistent myelosuppression (e.g., after previous cytotoxic therapy)
Severe hepatic impairment
Severe myocardial insufficiency, recent myocardial infarction, or severe arrhythmias
Previous therapy with maximum cumulative doses of epirubicin or other anthracyclines
Pregnancy and lactation

Drug Interactions

Cimetidine

Increases plasma concentration of epirubicin; co-administration should be avoided.

Paclitaxel

May increase plasma levels of epirubicin and its metabolites, increasing toxicity. Administer epirubicin first.

Live vaccines

Avoid due to immunosuppression.

Other myelosuppressive agents

Increased risk of severe myelosuppression.

Cardiotoxic agents (e.g., trastuzumab, cyclophosphamide)

Increased risk of cardiotoxicity. Careful cardiac monitoring is required.

Storage

Store unopened vials in a refrigerator at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze. Reconstituted solutions should be used immediately or stored for a short period as directed by the manufacturer.

Overdose

Acute overdose results in severe myelosuppression (especially leukopenia and thrombocytopenia), gastrointestinal toxicity (mucositis), and acute cardiac toxic effects. Management is supportive, including blood transfusions, antibiotics for infections, and symptomatic care.

Pregnancy & Lactation

Epirubicin is contraindicated during pregnancy due to its genotoxic and teratogenic effects. Women of childbearing potential should use effective contraception. It is also contraindicated during lactation due to excretion in breast milk and potential for serious adverse reactions in nursing infants.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 vial (2 mg Epirubicin Hydrochloride)

Shelf Life

Typically 2-3 years for unopened vials when stored correctly. Reconstituted solutions have limited stability.

Availability

Hospitals, Specialized Oncology Pharmacies

Approval Status

Approved (for various oncology indications)

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Epirubicin has been extensively studied in numerous clinical trials for various cancer types, both as a single agent and in combination with other chemotherapeutic drugs or targeted therapies, continually evaluating efficacy, safety, and optimal dosing regimens.

Lab Monitoring

Complete blood count with differential (prior to each cycle and during treatment)
Cardiac function monitoring (e.g., LVEF by ECHO or MUGA scan, ECG) before and during treatment, especially at higher cumulative doses
Liver function tests (AST, ALT, bilirubin) prior to each cycle
Renal function tests (creatinine, BUN)

Doctor Notes

Careful cardiac monitoring (LVEF) is essential before and during treatment, especially for cumulative doses approaching 900 mg/m².
Manage myelosuppression proactively with dose adjustments or growth factors.
Monitor liver function, as impaired hepatic function can increase toxicity.
Ensure proper administration technique to prevent extravasation, which requires immediate management.
Educate patients about potential side effects and when to seek immediate medical attention.

Patient Guidelines

Report any fever, unusual bleeding, bruising, or signs of infection immediately.
Inform your doctor if you experience chest pain, shortness of breath, or swelling in your feet or ankles.
Maintain good oral hygiene to prevent mouth sores.
Stay well-hydrated.
Avoid contact with people who have infections.

Missed Dose Advice

If a dose is missed, contact your doctor or healthcare provider immediately to reschedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Epirubicin may cause fatigue, nausea, or dizziness. Patients should be advised to avoid driving or operating machinery if they experience these effects.