|Drug Name:||Epirubicin hydrochloride|
Epirubicin HCl is provided as a preservative-free, ready-to-use solution.Epirubicin HCl should be administered into the tubing of a freely flowing intravenous infusion (0.9% sodium chloride or 5% glucose solution).
Patients receiving initial therapy at the recommended starting doses of 100 to 120 mg/m2 should generally have epirubicin infused over 15 to 20 minutes.
For patients who require lower epirubicin starting doses due to organ dysfunction or who require modification of epirubicin doses during therapy, the epirubicin infusion time may be proportionally decreased, but should not be less than 3 minutes.
This technique is intended to minimize the risk of thrombosis or perivenous extravasation, which could lead to severe cellulitis, vesication, or tissue necrosis.
A direct push injection is not recommended due to the risk of extravasation, which may occur even in the presence of adequate blood return upon needle aspiration.
Venous sclerosis may result from injection into small vessels or repeated injections into the same vein (see PRECAUTIONS).
Epirubicin HCl should be used within 24 hours of first penetration of the rubber stopper.Discard any unused solution.
Epirubicin HCl injection should be administered only under the supervision of qualified physicians experienced in the use of cytotoxic therapy.
Before beginning treatment with epirubicin, patients should recover from acute toxicities (such as stomatitis, neutropenia, thrombocytopenia, and generalized infections) of prior cytotoxic treatment.
Also, initial treatment with epirubicin HCl should be preceded by a careful baseline assessment of blood counts; serum levels of total bilirubin, AST, and creatinine; and cardiac function as measured by left ventricular ejection function (LVEF).
Patients should be carefully monitored during treatment for possible clinical complications due to myelosuppression.
Supportive care may be necessary for the treatment of severe neutropenia and severe infectious complications.Monitoring for potential cardiotoxicity is also important, especially with greater cumulative exposure to epirubicin.