Epirubicin

 

This is the ‘E’ in the IVE chemotherapy regime

 

Possible side effects

Each person's reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. The side effects described in this section will not affect everyone who is given epirubicin, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common and the less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor or chemotherapy nurse.

 

Hair loss

This usually starts 3-4 weeks after the first dose of epirubicin, although it may happen earlier. Hair may be lost completely or may just thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and the hair will grow again once the treatment ends.

 

Nausea (feeling sick) and vomiting

There are now very effective anti-sickness drugs to prevent or greatly reduce nausea and vomiting. If you do feel sick it may begin a few hours after the treatment is given and last for up to a day. If the sickness is not controlled, or continues, tell your doctor, who can prescribe other drugs, which may be more effective.

 

Temporary reduction in the production of blood cells by the bone marrow

This can result in anaemia leading to tiredness; an increased risk of bruising or bleeding and an increased risk of infection. This effect begins around seven days after the treatment has been given and the number of the blood cells in the blood reaches its lowest point at 10-14 days after the chemotherapy. The number of blood cells then gradually

 

Sore mouth and taste change

Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your doctor if you do have any of these problems as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed. You may notice that your food tastes different. Normal taste will come back after the treatment finishes.

 

Discoloured urine

Your urine may become a pink-red colour. This may last up to a day after you have had the epirubicin, and is due to the colour of the drug. It is quite normal.

 

Skin changes

Epirubicin can cause a rash, which may be itchy. Your doctor can prescribe medicine to help with this. Areas which have previously been treated with radiotherapy may become red and sore. Let your doctor know if this happens. The skin over the vein used for the injection may become discoloured. Your skin may darken, due to excess production of pigment. The darkening usually returns to normal a few months after the treatment has finished.

 

Tiredness and a general feeling of weakness

It is important to allow yourself plenty of time to rest.

 

Less common side effects

 

Diarrhoea

This can usually be controlled easily with medicine, but let your doctor know if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea.

 

Changes to nails Your nails may become darker. White lines may appear on them. These changes grow out over a few months once the treatment has finished.

 

Additional information

If epirubicin leaks into the tissue around the vein it can damage the tissue in that area. If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site, it is very important that you tell your doctor or nurse.

If the area around the injection site becomes red or swollen at any time you should either tell the doctor or nurse on the ward, or if you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.

Some people have hot flushes when the drug is being given.

Some medicines can be harmful to take when you are having chemotherapy. Always tell your doctor about any other medicine you are taking.

 

Fertility

Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

 

Contraception It is not advisable to become pregnant or father a child while taking epirubicin as it may harm the developing foetus. It is important to use effective contraception whilst taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor

 

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