Introduction

Name

• Epirubicin (4'-Epi-doxorubicin).

Class of drug

• Cytotoxic anthracycline antibiotic.

Description

Chemical name

• (8S-cis)-10-[(3-Amino-2,3,6-trideoxy-alpha-L-arabino-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-5,12-naphthacenedione.

Molecular formula

• C27H29NO11.

Storage requirements

• After reconstitution the drug is stable for 24 hours at room temperature.
• Protect from light.

Uses

Indications

• In the dog, the drug has only been assessed against lymphomas.
• In man, epirubicin has demonstrated efficacy against human breast, ovarian, lung, lymphoma, soft tissue sarcomas, and acute non-lymphocytic leukemia.
• It may be used alone or with other anti-neoplastic therapies Chemotherapy: general principles.

Administration

Precautions

Interactions

with other drugs

Heparin

• Forms precipitate with Epirubicin.

with diagnostic tests

• Dogs should be periodically monitored with ECGs and/or echocardiograms.
• Complete CBC and platelet count should be monitored whenever therapy is given. If the neutrphil count drops below 3x10³/dl or if the platelet count drops below 150x10³/dl, treatment should be suspended. Once the counts have stabilized doxorubicin can then be restarted at the same dose.
• If hematological toxicity occurs again, or if gastrointestinal toxicity is recurrent the dose should be reduced to 25 mg/m².

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.

Other sources of information

• Fischer D S, Knobf M T et al (2003) The Cancer Chemotherapy Handbook. 6th edn. Philadelphia, PA, Mosby. pp 113-114.
• Based on Small Animal Formulary. Tennant, Bryn (1999) 3rd edn. Cheltenham: BSAVA.