Monograph

L01DB03 - Epirubicin

Propably not porphyrinogenic

Rationale

Possible CYP substrate. No observations of interference with CYP-metabolism of other drugs. Not listed as CYP-inducer or inhibitor. Side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Chemical description

Epirubicin is the 4-epimer of doxorubicin, and is an anthracycline glycoside antineoplastic antibiotic.

Therapeutic characteristics

Epirubicin is used, alone or in combination with other antineoplastics, in the treatment of acute leukaemias, lymphomas, multiple myeloma, and in solid tumours including Wilms tumour, cancer of the bladder, breast, and stomach. Usually administered as an intravenous injection or infusion, but may also be given as an intravescical installation. Common adverse reactions of epirubicin that can be confused with an acute porphyric attack are nausea and vomiting. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Metabolism and pharmacokinetics

Epirubicin is extensively and rapidly metabolized in the liver. Baumhakel (2001) found no inhibitory effect on CYP 3A4, and states that

Published experience

Used uneventfully in the treatment of breast cancer in a 42 year old AIP woman (Kristiansen, 2006).

IPNet drug reports

Uneventful use reported in 1 patient with acute porphyria.

Similar drugs

Explore alternative drugs in similar therapeutic classes L01D / L01DB or go back.

References

#	Citation details	PMID
*	Scientific articles
1.	Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.
2.	Screening for inhibitory effects of antineoplastic agents on CYP3A4 in human liver microsomes. Baumhäkel M, Kasel D, et al. Int J Clin Pharmacol Ther. 2001;39(12):517-28.
3.	Treatment and treatment considerations in a patient with advanced breast cancer and acute intermittent porphyria. Kristiansen C, Langkjer ST. Acta Oncol. 2006;45(3):337-9.
*	Drug reference publications
4.	McEvoy GK, editor. Epirubicin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (06.05.10).
5.	Sweetman SC, editor. Martindale: The complete drug reference. Epirubicin. Pharmaceutical Press 2009.

Citation details

PMID

Scientific articles

Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.

Screening for inhibitory effects of antineoplastic agents on CYP3A4 in human liver microsomes.

Baumhäkel M, Kasel D, et al. Int J Clin Pharmacol Ther. 2001;39(12):517-28.

Treatment and treatment considerations in a patient with advanced breast cancer and acute intermittent porphyria.

Kristiansen C, Langkjer ST. Acta Oncol. 2006;45(3):337-9.

Drug reference publications

McEvoy GK, editor. Epirubicin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (06.05.10).

Sweetman SC, editor. Martindale: The complete drug reference. Epirubicin. Pharmaceutical Press 2009.

Tradenames

This list comprises raw data collected from different countries. In some cases, a more comprehensive list of available drug packages is included. Consequently, very similar terms may therefore appear multiple times. Bold names are the searchable terms, while the gray names that follow are all mapped to the bolded term.

Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors. We strive to improve it continuously.

Show more details and information about the listed tradenames

Epirubicine HCl Pharmachemie 2 mg/ml, oplossing voor injectie of intraveneuze infusie · Epirubicine Hikma 2 mg/ml, oplossing voor injectie · Epirubicinehydrochloride Accord 2 mg/ml oplossing voor injectie of infusie

Epirubicin · Epirubicin Eugia 2 mg/ml sol. inj. i.v. flac. · Epirubicin Hikma 2 mg/ml sol. i.v?sic./inj. i.v. flac. · Epirubicin Hikma Farmaceutica 2 mg/ml sol. inj. i.v. flac. · Epirubicine · Epirubicine Accord Healthcare 2 mg/ml sol. inj./perf./sol. i.v?sic. i.v. flac. · Epirubicine Teva 2 mg/ml sol. inj./perf. i.v. flac. · Farmorubicine · Farmorubicine 10 mg sol. i.v?sic./inj. i.v. flac. · Farmorubicine 200 mg sol. i.v?sic./inj. i.v. flac. · Farmorubicine 50 mg sol. i.v?sic./inj. i.v. flac.

EPIRUBICINA ACCORD 2 mg/ml SOLUCION INYECTABLE O PARA PERFUSION EFG · EPIRUBICINA AUROVITAS 2 mg/ml SOLUCION INYECTABLE EFG · Epirubicina Hikma 2 mg/ml Solucion Intravesical e Inyectable efg · EPIRUBICINA HISPAFARMA 2 mg/ml SOLUCION INYECTABLE · EPIRUBICINA TEVA 2 mg/ml SOLUCION INYECTABLE Y PARA PERFUSION EFG · Farmorubicina · FARMORUBICINA 10 mg POLVO Y DISOLVENTE PARA SOLUCION INYECTABLE Y PARA PERFUSION · FARMORUBICINA 2 mg/ml SOLUCION INYECTABLE Y PARA PERFUSION