ellence

Ellence (epirubicin) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Ellence is used to treat breast cancer.

Ellence may also be used for purposes not listed in this medication guide.

Important information

You should not use this medication if you have an untreated or uncontrolled infection, severe liver disease, severe heart problems, or if you have recently had a heart attack.

Ellence may cause dangerous effects on your heart. Call your doctor at once if you have chest pain, shortness of breath (even with mild exertion), swelling, or rapid weight gain.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Ellence is injected. Call your doctor if you have irritation or skin changes where the injection was given.

Ellence can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

Using Ellence may increase your risk of other types of cancer, such as leukemia.

Before receiving Ellence

Before you are treated with Ellence, tell your doctor about all other cancer medications and treatments you have received, including radiation.

You should not use Ellence if you are allergic to epirubicin or similar medications (Cerubidine, Adriamycin, Idamycin, Novantrone), or if you have:

• an untreated or uncontrolled infection (including mouth sores);

• severe liver disease;

• severe heart problems; or

• if you have recently had a heart attack.

To make sure Ellence is safe for you, tell your doctor if you have:

• liver or kidney disease;

• bone marrow suppression;

• heart disease; or

• if you have been treated before with doxorubicin, daunorubicin, epirubicin, idarubicin, or mitoxantrone.

Using Ellence may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

Do not use Ellence if you are pregnant. It could harm the unborn baby. Tell your doctor if you become pregnant during treatment.

Use birth control to prevent pregnancy while you are receiving this medicine, whether you are a man or a woman. Ellence use by either parent may cause birth defects.

It is not known whether epirubicin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using Ellence.

How is Ellence given?

Ellence is injected into a vein through an IV. A healthcare provider will give you this injection.

Ellence is usually given together with other cancer medications. You may be given other medications to prevent nausea, vomiting, or infections.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Ellence is injected.

If any of this medication accidentally gets on your skin, wash it thoroughly with soap and warm water.

Ellence can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Ellence injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Epirubicin can pass into body fluids (including urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using Ellence, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Ellence side effects

Get emergency medical help if you have any signs of an allergic reaction to Ellence: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have:

• feeling short of breath, even with mild exertion;

• swelling, rapid weight gain (especially in your face and midsection);

• irritation or skin changes where the injection was given;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• fast, slow, or uneven heartbeats;

• anxiety, sweating, severe shortness of breath, wheezing, gasping for breath;

• chest pain, sudden cough, cough with foamy mucus, rapid breathing, coughing up blood;

• lower back pain, blood in your urine, little or no urinating;

• numbness or tingly feeling around your mouth, weak pulse, overactive reflexes, confusion, fainting;

• muscle weakness, tightness, or contraction;

• fever, chills, body aches, flu symptoms, sores in your mouth and throat; or

• pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Common Ellence side effects may include:

• hot flashes, missed menstrual periods;

• temporary hair loss;

• feeling weak or tired;

• mild nausea, diarrhea; or

• eye redness, puffy eyelids.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Ellence?

Many drugs can interact with Ellence. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Ellence, especially:

• acetaminophen (Tylenol);

• auranofin or gold injections to treat arthritis;

• cimetidine;

• rosiglitazone;

• an antibiotic or antifungal medication;

• an antidepressant--amitriptyline, doxepin, clomipramine, desipramine, imipramine, nortriptyline;

• birth control pills or hormone replacement therapy;

• cholesterol medications--atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin;

• heart or blood pressure medicine--amlodipine, atenolol, carvedilol, digoxin, diltiazem, enalapril, labetalol, lisinopril, methyldopa, nifedipine, verapamil, and others;

• HIV/AIDS medications;

• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• other cancer medications, especially docetaxel or paclitaxel; or

• seizure medications--carbamazepine, divalproex, phenobarbital, phenytoin, valproic acid, and others.

This list is not complete and many other drugs can interact with Ellence. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.