Indications
Idarubicin is an anticancer medicine used mainly to treat acute myeloid leukaemia (AML), a fast growing cancer of the blood and bone marrow, usually together with other medicines such as Cytarabine to bring the disease into remission. It may also be used in some cases of acute lymphoblastic leukaemia.
How It Works
Idarubicin belongs to the anthracycline group. It slips between the strands of DNA in cancer cells and blocks an enzyme called topoisomerase II, which cells need to copy their DNA. This stops the cancer cells from dividing and causes them to die. It also affects healthy fast dividing cells, which explains many of its side effects.
Dosage and Administration
Idarubicin is given as prescribed by a cancer specialist. The injection is given into a vein by a doctor or nurse in hospital, usually over a few days as part of a treatment cycle; capsule forms are taken by mouth exactly as directed. The dose is calculated from body size, blood counts, heart, liver and kidney function, and earlier anthracycline treatment.
Interactions
Other medicines that suppress the bone marrow increase the risk of low blood counts. Previous or combined treatment with other anthracyclines such as Doxorubicin, or with Trastuzumab, or radiotherapy to the chest, increases the risk of heart damage. Live vaccines should be avoided during treatment. Tell the doctor about all medicines, including blood thinners such as Warfarin.
Contraindications
- Allergy to idarubicin or other anthracyclines.
- Severe liver or kidney impairment.
- Serious heart disease, such as heart failure, recent heart attack or severe rhythm problems.
- Severe bone marrow suppression not caused by the leukaemia, or uncontrolled infection.
- Having already received the maximum lifetime amount of anthracyclines.
- Breastfeeding.
Side Effects
Very common: low white cells, red cells and platelets (raising the risk of infection, tiredness and bleeding), nausea, vomiting, mouth sores, diarrhoea, hair loss and red coloured urine for a day or two. Other effects include heart rhythm changes or weakening of the heart muscle (sometimes appearing years later), liver changes, skin rash and darkening of nails. If the injection leaks out of the vein it can cause severe tissue damage.
Get urgent medical help for fever of 38°C or more, chills, bleeding or unusual bruising, chest pain, shortness of breath, swollen ankles, a racing or irregular heartbeat, or pain, redness or swelling at the injection site.
Pregnancy and Lactation
Idarubicin can harm an unborn baby. Pregnancy must be avoided during treatment, and both women and men should use effective contraception during and for some months after treatment as advised by the doctor. Do not breastfeed during treatment.
Precautions and Warnings
It should only be used by specialists experienced in cancer chemotherapy. Blood counts, heart function (for example an echocardiogram), liver and kidney tests and uric acid are checked regularly. Drink plenty of fluids unless told otherwise. Avoid people with infections, and report any sign of infection quickly. The medicine may reduce fertility.
Overdose
Overdose can cause severe bone marrow suppression, severe mouth and gut damage and acute heart problems. It is managed in hospital with supportive care such as transfusions, antibiotics and heart monitoring.
Therapeutic Class
Antineoplastic, anthracycline antibiotic
Storage
Hospital and specialist medicine: store as directed on the pack, out of the reach of children. Cytotoxic waste must be handled and disposed of safely.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.