When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to epirubicin, doxorubicin, daunorubicin, idarubicin, or mitoxantrone. You should not receive it if you are pregnant, or if you have heart failure or had a recent heart attack.

How to Use This Medicine:
Injectable

• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how epirubicin works. Tell your doctor if you are also using any of the following:
  
  • Cimetidine
  • Docetaxel
  • Paclitaxel
  • Trastuzumab
• Tell your doctor if you are also receiving radiation treatments.
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, heart disease, heart rhythm problems, gout, or any type of infection.
• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• This medicine may cause the following problems:
  
  • Heart problems
  • Increased risk of leukemia
  • Tumor lysis syndrome
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may turn your urine red for 1 or 2 days after your treatment. This is normal and nothing to worry about, but can stain your clothing.
• Cancer medicine can cause nausea or vomiting, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about other ways to control any nausea or vomiting that might happen.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Decrease in how much or how often you urinate
• Fast, slow, or uneven heartbeat
• Fever, chills, cough, sore throat, body aches
• Pain, itching, burning, redness, swelling, or a lump under your skin where the needle is placed
• Shortness of breath, cold sweat, and bluish-colored skin
• Swelling in your hands, ankles, or feet
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Changes in menstrual periods
• Diarrhea, nausea, vomiting
• Hair loss
• Sores or white patches on your lips, mouth, or throat
• Tiredness
• Warmth or redness in your face, neck, arms, or upper chest

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088