Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Anemia: This medication can reduce the number of red blood cells in the body, causing anemia. Red blood cells are responsible for carrying oxygen through the body, where it is used by the muscles and other tissues. If you develop symptoms of anemia, such as weakness, dizziness, or shortness of breath, contact your doctor.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.
Fertility: Epirubicin can cause changes to sperm in men, possibly causing birth defects. Women may experience reduced or stopped ovulation or menstruation. In rare cases, women may experience premature menopause. Both women and men receiving epirubicin should use effective contraceptive methods.
Gout and kidney stones: Epirubicin may increase the levels of uric acid in the body, increasing the risk of developing gout or kidney stones. If you develop painful, warm, and swollen joints or difficulty with urination, contact your doctor as soon as possible. People with a history of gout or kidney stones should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Heart disease: Epirubicin may cause heart failure during treatment or after treatment has finished. The risk of abnormal heart rhythm, congestive heart failure, and a weakened heart (cardiomyopathy) is increased for people with preexisting heart disease. People with heart disease or an increased risk of heart disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills.
Secondary leukemia: There is some evidence to suggest that people who receive treatment with epirubicin are at an increased risk of developing acute myeloid leukemia (AML). Talk to your doctor if you have concerns.
Pregnancy: Although there is no conclusive information regarding the effects of epirubicin during pregnancy, due to the potential for toxic effects, this medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if epirubicin passes into breast milk. If you are a breast-feeding mother and are receiving this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The risk of heart problems resulting from the use of epirubicin is greater in children under 2 years of age.