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Idarubicin

(eye-duh-roo-buh-sin)

Trade/other name(s): Idamycin

Why would this drug be used?

Idarubicin is used to treat certain kinds of leukemia (AML and other non-lymphocytic types) along with other drugs.

How does this drug work?

Idarubicin is a member of a general group of chemotherapy drugs known as anthracycline antibiotics. It prevents cells from making DNA and/or RNA, which slows or stops cell growth.

Before taking this medicine

Tell your doctor…

  • 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, 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, daunorubicin, or epirubicin (similar types of chemotherapy), or any other drug that may cause heart damage. Your dose of idarubicin may need to be adjusted.
  • If you have ever had radiation treatment to your chest. This may increase your risk of heart damage.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. If either the male or female is taking this drug at the time of conception or during a pregnancy, it may cause birth defects. If you're sexually active while taking this drug, you should 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 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.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

No serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Idarubicin is injected into the vein over about 15 minutes. If you feel any pain, burning, or discomfort in the vein, tell your nurse right away. Nausea and vomiting are common side effects of taking this drug. You should be given anti-nausea medicine to take before and after your dose. The dose and how often you get the medicine depends on several factors: your size, your blood counts, how well your liver is working, and the type of cancer being treated. Your nurse or doctor should check your blood counts before each treatment. Your treatment will be delayed if they're too low. You may take this medicine in addition to other chemotherapy drugs.

Precautions

Idarubicin is given into the vein (IV). If the drug leaks out of the vein and under the skin, it may damage the tissue, causing pain, ulceration, and scarring. Tell the nurse right away if you notice redness, pain, or swelling at or near the IV.

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.

Idarubicin 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.

Do not get any immunizations (vaccines), 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.

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 (100.5o or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

Idarubicin 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 can cause a condition known as hand-foot syndrome, in which a person may experience pain, numbness, tingling, reddening, or swelling in the hands or feet. Peeling, blistering, or sores on the skin in these areas are also possible. Let your doctor know right away if you notice any of these symptoms.

This drug can kill large numbers of cancer cells within the first 24 hours of treatment, spilling the cells' contents into the blood. This can lead to electrolyte imbalances and tumor lysis syndrome, which can result in serious kidney damage and other problems. If your doctor thinks you may be at risk, he or she will give you medicines and/or fluids to help prevent it. If you notice pain in the back or sides of your chest, or blood in your urine, call your doctor right away.

Idarubicin can cause radiation recall. If you have ever had radiation therapy, the skin or tissue damage from prior radiation treatment can become red and appear damaged again after you get this drug. Tell your doctor or nurse if your skin gets red in areas where radiation was given.

When large doses are given, there's a chance idarubicin may injure the heart muscle. Your doctor will test your heart before and during your first treatment so that any damage can be found early. During and after your treatment with this 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.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • decreased white blood cell count with increased risk of infection*
  • decreased platelet count with increased risk of bleeding*
  • nausea*
  • vomiting*
  • abdominal pain
  • decreased appetite
  • sores in mouth or on lips
  • hair loss or thinning*
  • skin rash

Less common

  • darkening of nail beds
  • diarrhea
  • fever
  • abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any.)

Rare

  • inflammation of the liver
  • heart damage with shortness of breath and swollen feet and ankles, which can happen months or years after treatment*
  • irregular heartbeat*
  • tumor lysis syndrome, kidney damage*
  • pain, tingling, blistering, or peeling skin on palms and soles of feet*

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1990.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 11/25/2009
Last Revised: 11/25/2009