• If you are allergic to anything, including medicines, dyes, additives, or foods.

• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.

• If you have previously been treated for cancer with doxorubicin, epirubicin, or idarubicin (similar types of chemotherapy), or any other drug that may result in heart damage. Your dose of daunorubicin may need to be adjusted.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.

• If you are breastfeeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.

• If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.

This drug can cause allergic reactions in some people. Mild reactions usually consist of fever and chills. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), fever or chills, hives (welts), nausea, itching, headache, coughing, shortness of breath, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms as you are being given the drug.

Do not get any immunizations (vaccinations), either during or after treatment with this drug, without your doctor's OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.

Daunorubicin causes the urine to turn reddish for 1 to 2 days after each dose is given. This is normal while your body gets rid of the drug, but may stain clothes.

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

Daunorubicin may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

This drug may cause hair loss. You may want to talk to your doctor or nurse about getting a wig before starting treatment. If your insurance does not cover it, there may be other resources to help you. Hair loss is usually temporary, and your hair will likely grow back during or after treatment.

Daunorubicin can injure the heart muscle when large doses are given. Your doctor will test your heart before you receive your first treatment, and then during the treatment. This way, any damage can be found early. After you have finished taking the drug, it is still important to let your doctor know right away if you notice shortness of breath, swollen feet or ankles, or irregular heartbeat. These effects can show up months or years after receiving the drug.

This drug can raise the blood level of uric acid (hyperuricemia), which can worsen gout and cause serious kidney damage. If your doctor feels you might be at risk, he or she will give you medicines and/or fluids during treatment to help prevent this.

Because of the way this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would likely be years after the drug is used. If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

• decreased white blood cell count with increased risk of infection*
• nausea*
• vomiting*
• decreased platelet count with increased risk of bleeding*
• hair loss*
• darkened fingernails and toenails

• radiation recall skin changes*
• rash
• fetal changes if taken while you are pregnant or if you become pregnant while taking this drug
• anemia (low red blood cell count)

• temporary changes in electrocardiogram (EKG)
• loosening of fingernails
• fever*
• chills*
• abdominal pain
• heart damage with shortness of breath, swollen feet and ankles, which can happen months or years after treatment*
• irregular heartbeat
• sores in mouth or on lips
• severe allergic reaction*
• leukemia or myelodysplastic syndrome, which may happen years after treatment*

*See "Precautions" section for more detailed