Epirubicin

Epirubicin: Uses, Dosage and Side Effects

Overview

• Epirubicin is a semisynthetic stereoisomer of doxorubicin.
• Intracellularly its metabolism results in the production of cytotoxic free radicals.
• It also binds irreversibly to DNA, thereby preventing replication and can alter cell membrane functions.

Uses of Epirubicin

• Treatment of lymphoma and also as an adjunct in the management of splenic haemangiosarcoma, canine histiocytic sarcoma and sporadically in other sarcomas
  and carcinomas.
• Epirubicin has been used in cats with feline injection site sarcoma.

Dose of Epirubicin in Dogs and Cats

Dogs:

• All uses: 30 mg/m2 i.v. q3wk; maximum total dose not to exceed 240 mg/m2.
• In dogs weighing <10 kg a dose of 1 mg/kg should be used.

Cats:

• 25 mg/m2 or 1 mg/kg i.v. q3wk.

Side Effects of Epirubicin in Dogs and Cats

• Acute anaphylactic reactions (should be treated with adrenaline, steroids and fluids).
• It may cause a dose–dependent cumulative cardiotoxicity in dogs.
•  It may also cause tachycardia and arrhythmias on administration.
•  Anorexia, vomiting, pancreatitis, severe leucopenia, thrombocytopenia, haemorrhagic
  gastroenteritis and nephrotoxicity are major adverse effects.
• If the neutrophil count drops below 2.5 × 109 or if the platelet count drops below 50 × 109, treatment should be suspended.
•  Dogs with the ABCB1 (MDR1) mutation may be at higher risk of toxicity.

Contraindications of Epirubicin in Dogs and Cats

• No information is available.

Some Notes:

• Epirubicin is incompatible with heparin; a precipitate will form.
• Increased risk of myelosuppression when used in combination with cyclophosphamide.