Anthracin 50 Mg Injection 1 No's

• Breast cancer, including after surgery in early breast cancer with affected lymph nodes, and in advanced disease
• Stomach (gastric) cancer
• Head and neck cancer
• Liver (hepatic) cancer
• Leukaemia
• Lung cancer, including small cell and non-small cell lung cancer
• Malignant lymphomas
• Ovarian cancer
• Pancreatic cancer
• Cancer of the sigmoid colon and rectum
• Soft-tissue sarcomas

• If you have had a severe allergic reaction to epirubicin, to other anthracyclines or anthracenediones such as doxorubicin, or to any ingredient in this medicine
• If you are breastfeeding
• If your bone marrow is persistently suppressed, with very low white cell or platelet counts
• If you have severe liver impairment
• If you have disease of the heart muscle (cardiomyopathy)
• If you have had a recent heart attack
• If you have severe heart rhythm abnormalities
• If you have unstable angina
• If you have an acute infection affecting the whole body
• If you have already received the maximum lifetime total of epirubicin or other anthracyclines and anthracenediones

• Infection
• Fever
• Low white blood cell count (leukopenia and neutropenia), increasing the risk of infection
• Low red blood cell count (anaemia), causing tiredness, pale skin and weakness
• Low platelet count (thrombocytopenia), causing easy bruising or bleeding
• Nausea and vomiting
• Diarrhoea
• Loss of appetite
• Mouth ulcers and inflammation of the lining of the mouth (stomatitis and mucositis)
• Hair loss (alopecia)
• Skin toxicity
• Red colouring of the urine for 1 to 2 days after a dose, caused by the colour of the medicine
• Red or irritated eyes (conjunctivitis)
• Feeling generally unwell (malaise)
• Abnormal liver enzymes on blood tests
• Absent menstrual periods in women (amenorrhoea)
• Absence of sperm in men (azoospermia)

• Fever with a very low white cell count (febrile neutropenia)
• Serious infections such as sepsis and pneumonia
• Hot flushes and flushing of the skin
• Inflammation of the vein used for the drip (phlebitis)
• Bleeding
• Dizziness and a burning sensation
• Inflammation of the food pipe (oesophagitis)
• Stomach pain, and erosions or ulcers in the digestive tract
• Skin rash, itching and darkening of the skin or nail beds
• Chills
• Redness at the drip site
• Weakness (asthenia)
• Reduced heart pumping function on scans (decreased ejection fraction)

• Heart problems: Breathlessness, leg swelling, sudden weight gain, or fast/irregular heartbeat may indicate heart damage, which can occur during or after treatment.
• Serious infection: Fever, chills, sore throat, or confusion, particularly with low white blood cell counts, may indicate a serious infection or sepsis.
• Unusual bleeding or bruising: Bleeding gums, frequent nosebleeds, or dark, tarry stools may indicate low platelet counts.
• Injection-site leakage: Burning, pain, redness, or swelling at the IV site may indicate extravasation, which can cause severe tissue damage.
• Severe allergic reaction: Facial swelling, rash, or difficulty breathing requires immediate medical attention.
• Tumour lysis syndrome (TLS): Rapid cancer-cell breakdown can cause electrolyte abnormalities, high uric acid, and kidney problems.
• Blood clots: Seek urgent care for sudden chest pain, breathlessness, or leg swelling.
• Secondary leukaemia: Rarely, anthracycline treatment can increase the risk of developing a secondary leukaemia, particularly after prolonged or intensive treatment.

Other General Warnings

• If you develop fever, chills, or signs of infection, your white blood cell count may be low.
• You notice unusual bruising or bleeding.
• You develop breathlessness, leg swelling, sudden weight gain, or a racing heartbeat, which may indicate heart problems.
• You experience pain, burning, redness, or swelling at the infusion site, which may indicate extravasation.
• You have liver or kidney problems, as you may need a dose adjustment.
• You have heart disease, previous anthracycline treatment, or chest radiotherapy, as these can increase the risk of heart damage.
• You have not recovered from significant toxicity from previous chemotherapy.
• You are planning to have children, as epirubicin may affect fertility in both men and women.

• Anthracin injection is administered only into a vein (IV) by trained healthcare professionals in a hospital or cancer clinic. It is given through a freely running IV infusion and must not be swallowed or administered into a muscle or the spine.
• Your doctor determines the dose and treatment schedule based on your body surface area, blood counts, liver and kidney function, and previous anthracycline exposure. Your doctor will also monitor your cumulative anthracycline dose because of the risk of heart damage.
• Do not miss or postpone scheduled treatment visits without consulting your doctor.

• Anthracin injection is stored and handled by trained hospital staff, not at home.
• Store unopened vials at 2°C–8°C, in the original packaging, and protect them from light.
• Store and use diluted solutions according to the product-specific instructions.
• Healthcare staff dispose of unused medicine, vials, tubing, and needles using cytotoxic waste procedures.
• Pregnant personnel should avoid handling Anthracin injection where possible due to its cytotoxic and reproductive risks.

• Red or pink urine for 1–2 days after treatment can happen because of the medicine's colour and is usually harmless.
• Report fever or chills immediately, as infection can become serious when blood counts are low.
• Seek medical attention for breathlessness, leg swelling, sudden weight gain, or a racing heartbeat, which may indicate heart problems.
• Attend all scheduled blood tests and heart assessments.
• Report stinging, burning, pain, or swelling at the infusion site immediately, as extravasation can cause severe tissue damage.
• Maintain good oral hygiene and report mouth ulcers or severe mouth pain.
• Avoid close contact with people who have infections while your blood counts are low.
• Use effective contraception during treatment and for the recommended period after the last dose. Discuss fertility preservation with your doctor before treatment.

Overdose

Missed a Dose

Interactions with other medicines

• Trastuzumab: Avoid combining with epirubicin unless specifically indicated under specialist supervision, because it increases the risk of heart failure. Anthracyclines may also need to be avoided for several months after trastuzumab.
• Live or live-attenuated vaccines: Avoid during treatment because they may increase the risk of serious infection. Inactivated vaccines may be less effective.
• Other heart-damaging medicines, previous anthracyclines, or chest radiotherapy: May increase the risk of heart damage.
• Other bone marrow-suppressing chemotherapy: May increase the risk of low blood counts and infection.
• Cimetidine: May increase epirubicin exposure and should generally be avoided.
• Paclitaxel or docetaxel: May alter epirubicin levels; careful scheduling may be required.
• Other medicines such as dexverapamil, quinine, and interferon alfa-2b may affect epirubicin exposure or toxicity.

Interactions with food items